Paralytic Ileus- A Rare but Serious Side-effect of Oral Capecitabine

Abstract

Paralytic ileus is a condition where the intestine becomes paralysed in the absence of any mechanical obstruction. The common causes are intra-abdominal surgery, severe metabolic problems and drugs. Many anticancer drugs and targeted therapy drugs are important causes of this toxicity. Early diagnosis and appropriate management are essential because if prolonged and untreated it can lead to death in the same way as in acute mechanical obstruction. Capecitabine is an orally administered prodrug of 5-Fluorouracil (5-FU) routinely used in breast and colorectal cancer. Paralytic ileus is a rare but recognised serious side-effect of oral capecitabine. Hereby, authors present a case of 53-year-old male patient, who was a postoperative case of colon cancer and was treated by adjuvant capecitabine based chemotherapy and subsequently, developed capecitabine induced paralytic ileus. He was managed successfully by standard conservative measures, avoiding unnecessary laparotomy.

Keywords

• colon cancer
• fluorouracil
• intestinal obstruction
• laparotomy