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Medline ® Abstract for Reference 17

of 'Enterotoxicity of chemotherapeutic agents'

An unusual case of bowel perforation.
Lazarescu RE, Bohm K
BMJ Case Rep. 2014;2014 Epub 2014 Jun 23.
Bowel perforation is a potentially fatal complication of obstruction, ischaemia, trauma, surgery and medications. It is recognised by clinical suspicion based on history, symptoms of severe abdominal pain and signs such as rebound tenderness, as well as imaging showing free air in the abdomen. Bevacizumab (aka avastin) is an antineoplastic recombinant monoclonal antibody that inhibits angiogenesis in a variety of malignancies. Colonic perforation is a recognised but rare complication of this therapy, likely due to aforementioned bowel ischaemia or compromised mucosal microcirculation which increases susceptibility to injury. We are presenting a case of an unrecognised bowel perforation caused in a patient with abdominal carcinomatosis.
Medicine Department, New York Hospital Queens-Weill Cornell affiliate, Flushing, New York, USA.