Journal of Nippon Medical School: Vol.66 No.1 page.037

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ArticleTitle Spontaneous gastrointestinal perforation in patients with lymphoma receiving chemotherapy and steroids Report of three cases

AuthorList Masayo Wada¹⁾ , Masahiko Onda²⁾ , Akira Tokunaga²⁾ , Teruo Kiyama²⁾ , Toshiro Yoshiyuki²⁾ , Norio Matsukura²⁾ , Kiyonori Furukawa²⁾ , Kaku Egami¹⁾ and Kiyohiko Yamashita²⁾

Affiliation ¹⁾ Department of Surgery, Tama-Nagayama Hospital, Nippon Medical School²⁾ First Department of Surgery, Nippon Medical School

Language EN

Volume 66

Issue 1

Year 1999

Page 37-40

Received October 26, 1998

Accepted November 11, 1998

Keywords malignant lymphoma, spontaneous perforation of gastrointestinal tract, chemotherapy, steroids

Abstract Spontaneous gastrointestinal perforations in three patients with lymphoma were considered to be treatment-related conditions. All three were diagnosed as having malignant lymphoma by histological examination, and treated with chemotherapy and steroids. Four to 14 days after the start of chemotherapy, they complained of abdominal pain and plain rentogenograms revealed pneumoperitoneum. The interval between the onset of peritonitis and operation was almost 24h. Emergency operations were carried out; one patient with a jejunal perforation underwent resection of the jejunum, another with a gastric perforation received a simple closure with omental patch, and the third with a gastric perforation underwent gastrectomy. Two patients recovered from the surgery, while the gastrectomy patient died due to sepsis. The favorable outcome of the surgical intervention is attributed to early diagnosis, prompt exploration, and selective operative procedures. We recommended a simple closure with omental patch for gastroduodenal perforation. Resection and primary anastomosis are possible only in the small bowel.

Correspondence to Akira Tokunaga, First Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan

ArticleTitle	Spontaneous gastrointestinal perforation in patients with lymphoma receiving chemotherapy and steroids Report of three cases
AuthorList	Masayo Wada¹⁾ , Masahiko Onda²⁾ , Akira Tokunaga²⁾ , Teruo Kiyama²⁾ , Toshiro Yoshiyuki²⁾ , Norio Matsukura²⁾ , Kiyonori Furukawa²⁾ , Kaku Egami¹⁾ and Kiyohiko Yamashita²⁾
Affiliation	¹⁾ Department of Surgery, Tama-Nagayama Hospital, Nippon Medical School²⁾ First Department of Surgery, Nippon Medical School
Language	EN
Volume	66
Issue	1
Year	1999
Page	37-40
Received	October 26, 1998
Accepted	November 11, 1998
Keywords	malignant lymphoma, spontaneous perforation of gastrointestinal tract, chemotherapy, steroids
Abstract	Spontaneous gastrointestinal perforations in three patients with lymphoma were considered to be treatment-related conditions. All three were diagnosed as having malignant lymphoma by histological examination, and treated with chemotherapy and steroids. Four to 14 days after the start of chemotherapy, they complained of abdominal pain and plain rentogenograms revealed pneumoperitoneum. The interval between the onset of peritonitis and operation was almost 24h. Emergency operations were carried out; one patient with a jejunal perforation underwent resection of the jejunum, another with a gastric perforation received a simple closure with omental patch, and the third with a gastric perforation underwent gastrectomy. Two patients recovered from the surgery, while the gastrectomy patient died due to sepsis. The favorable outcome of the surgical intervention is attributed to early diagnosis, prompt exploration, and selective operative procedures. We recommended a simple closure with omental patch for gastroduodenal perforation. Resection and primary anastomosis are possible only in the small bowel.
Correspondence to	Akira Tokunaga, First Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan