Case Reports in Oncology (Jul 2021)

Clostridium difficile Infection Leading to Intestinal Pneumatosis in a Patient with a Recent Diagnosis of Pancreatic Cancer Local Recurrence: A Case Report and Literature Review

  • Angel Ayumi Tome Uchiyama,
  • Moisés de Souza Martins Lopes,
  • Maira Nacimbem Marzinotto Vana,
  • Renata D’Alpino Peixoto

DOI
https://doi.org/10.1159/000513003
Journal volume & issue
Vol. 14, no. 2
pp. 1111 – 1117

Abstract

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Clostridium difficile infection (CDI) causing pneumatosis intestinalis (PI) is a rare event, described mostly in immunocompromised patients. We present the case of a 65-year-old female diagnosed with adenocarcinoma of the pancreas who underwent a duodenopancreatectomy with lymphadenectomy and adjuvant gemcitabine and capecitabine. Four months after the end of chemotherapy, she experienced abdominal pain and intermittent diarrhea which became aggravated within 6 months. CT scans revealed diffuse intestinal pneumatosis and recurrence of ductal adenocarcinoma. We hypothesize that local pancreatic cancer recurrence may lead to gastrointestinal dysmotility with consequent increased risk for CDI. The patient had almost complete resolution of PI during the CDI treatment, thus we believe that the CDI was directly responsible for PI in this case.

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