A Case of Portal Hypertension after the Treatment of Oxaliplatin Based Adjuvant- Chemotherapy for Rectal Cancer

Jun Heo; Keun Young Shin; Yong Hwan Kwon; Soo Young Park; Min Kyu Jung; Chang Min Cho; Won Young Tak; Young Oh Kweon

doi:10.4166/kjg.2011.57.4.253

Journal List > Korean J Gastroenterol > v.57(4) > 1006799

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Heo, Shin, Kwon, Park, Jung, Cho, Tak, and Kweon: A Case of Portal Hypertension after the Treatment of Oxaliplatin Based Adjuvant- Chemotherapy for Rectal Cancer

Case Report

Korean J Gastroenterol 2011;57(4):253-257.

Published online: 4 October 2011

DOI: https://doi.org/10.4166/kjg.2011.57.4.253

A Case of Portal Hypertension after the Treatment of Oxaliplatin Based Adjuvant- Chemotherapy for Rectal Cancer

Jun Heo, Keun Young Shin, Yong Hwan Kwon, Soo Young Park, Min Kyu Jung, Chang Min Cho, Won Young Tak, Young Oh Kweon

Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea

Correspondence to: Young Oh Kweon, Department of Internal Medicine, Kyungpook National University School of Medicine, 50, Samduck 2-ga, Jung-gu, Daegu 700-721, Korea. Tel: +82-53-420-5518, Fax: +82-53-425-9997, E-mail: yokweon@mail.knu.ac.kr

Received 14 July 2010 Revised 27 September 2010 Accepted 18 October 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We report herein a case of 35-years-old woman in whom portal hypertension (esophageal varix and splenomegaly) developed after 12 cycles of oxaliplatin based adjuvant chemotherapy for rectal cancer. She was transferred for the evaluation of etiology of new-onset portal hypertension. The esophageal varix and splenomegaly were absent before the oxaliplatin based adjuvant chemotherapy. Thorough history taking and serological exam revealed no evidence of chronic liver disease. Liver biopsy was done and there was no cirrhotic nodule formation. Instead, perivenular fibrosis was noted. Considering new development of esophageal varices and splenomegaly after 12 cycles of oxaliplatin-based adjuvant chemotherapy, we could conclude that portal hypertension in this patient were due to sinusoidal injury by oxaliplatin. Finally, we recommend regular follow-up with endoscopy and radiologic examination for checking the development of varices and for screening of varices and splenomegaly in patients with colorectal cancer who receive oxaliplatin-based chemotherapy.

Keywords: Portal hypertension, Esophageal varix, Splenomegaly, Oxaliplatin

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Fig. 1.

Endoscopic exam showing moderate sized, blue colored, beaded esophageal varices.

Fig. 2.

Abdominal computed tomographic finding of spleen. (A) Before operation and chemotherapy, the maximal spleen diameter was 103.41 mm. (B) After operation and chemotherapy (6 months after last chemotherapy), the maximal spleen diameter was 123.71 mm.

Fig. 3.

Histologic finding of the liver parenchyma. It revealed mininal perivenular fibrosis without cirrhotic nodules (A: Masson's trichrome stain,×100; B: Masson's trichrome stain, ×400).

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ORCID iDs: Won Young Tak
https://orcid.org/http://orcid.org/0000-0002-1914-5141
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