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Surgical management of spontaneous bowel perforation and fascial dehiscence in a patient on bevacizumab and pembrolizumab in the setting of active Clostridium difficile infection.
Mubashir, Mujtaba; Tang, Brian; DeBernardo, Robert L; Feng, Xiaoxi.
Afiliação
  • Mubashir M; General Surgery, Cleveland Clinic, Cleveland, Ohio, USA mujtabamubashir@gmail.com.
  • Tang B; General Surgery, Cleveland Clinic, Cleveland, Ohio, USA.
  • DeBernardo RL; Obstetrics and Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio, USA.
  • Feng X; General Surgery, Cleveland Clinic, Cleveland, Ohio, USA.
BMJ Case Rep ; 16(5)2023 May 03.
Article em En | MEDLINE | ID: mdl-37137546
Immunotherapy such as bevacizumab and pembrolizumab is used to treat an increasing number of malignancies. These medications have been associated with poor wound healing and several gastrointestinal complications, including intestinal perforations in rare cases. We present a unique case of a patient with metastatic cervical cancer on pembrolizumab and recent bevacizumab therapy, presenting with a colonic perforation requiring urgent exploratory laparotomy, in the setting of active Clostridium difficile infection. She required a second laparotomy shortly after due to fascial dehiscence, where a synthetic absorbable mesh was used for fascial approximation. We review the factors that led to these events and describe the surgical technique used for safe abdominal closure.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Perfuração Intestinal Tipo de estudo: Etiology_studies Limite: Female / Humans Idioma: En Revista: BMJ Case Rep Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Perfuração Intestinal Tipo de estudo: Etiology_studies Limite: Female / Humans Idioma: En Revista: BMJ Case Rep Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Reino Unido