Author(s): Prathusha Yerramilli and Asha Shah

Abstract: Immediate surgical intervention is often required for intestinal perforation to avoid the high morbidity and mortality of peritonitis and the complications associated with sepsis. (1, 2). Surgery is a definitive way to establish source control in the presence of intestinal leakage and is an effective approach in cancer patients to avoid delays in chemotherapy. However, micro perforations and contained perforations can be treated nonoperatively, especially in patients at elevated risk for surgery (2, 3, 4). This can also be considered in cancer patients without delaying planned chemotherapy. We report a case of intestinal microperforation in a 59-year-old female patient with metastatic breast cancer to the bone with malignant ascites and peritoneal carcinomatosis. Due to her hemodynamic stability and the high risk of operative complications in the setting of ascites and carcinomatosis, she was treated with nonoperative management. Throughout her hospital course, her vitals and abdominal examination remained stable, and she was safely managed nonoperatively and discharged home. Post hospitalization she had follow-up with oncology and the planned start date for chemotherapy was not delayed due to any concern for ongoing infection from nonoperative management. Management of intestinal perforation should be tailored to the patient's clinical status and comorbidities. Due to this patient's malignant ascites and carcinomatosis, operative intervention carried significant risk of respiratory compromise, marked shifts in body fluids, anastomotic leak, and wound healing complications (5).

DOI: 10.22271/27080056.2025.v7.i2c.151

Pages: 130-134 | Views: 64 | Downloads: 23

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