Gastrointestinal dysmotility in a patient with advanced lung cancer: paraneoplastic or druginduced?.

Autor: Dias, Raphael Figuiredo, Lana Diniz, Mirella Monique, Santos, Bruno Campos, Nobre, Vandack Alencar
Zdroj: BMJ Case Reports; 1/26/2021, Vol. 14, p1-5, 5p
Abstrakt: A 75-year-old man was hospitalised for bronchoscopy with biopsy due to a suspicious pulmonary mass at chest tomography. He had significant dyspnoea, constipation, nausea, vomiting, anorexia and a 33% loss of weight in the past 3 months. Biopsy revealed a pulmonary squamous cell carcinoma, which was inoperable. Tramadol used at home for 3months was replaced by morphine on admission. The patient remained constipated despite prokinetics and laxatives, leading to the diagnostic hypothesis of paraneoplastic motility disorder and opioid-induced constipation. Abdominal tomography ruled out the possibility of mechanical obstruction. As complications, the patient presented superior vena cava syndrome and opioid (morphine) intoxication. The patient died a few days later. The management of this case highlights the importance of multidisciplinary care and the challenges of palliative oncology care. Paraneoplastic motility disorder must always be considered among the mechanisms of intestinal dysfunction in patients with advanced oncological disease. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index