Bevacizumab is a monoclonal antibody which targets the vascular
endothelial growth factor molecule. It is indicated for
the treatment of recurrent and metastatic colorectal cancer.
A 66-year-old woman was operated with left hemicolectomy
who had a tumor in the left colon causing a total obstruction.
Her tumor stage was IV (T3N1M1). 5-Fluorouracil, folinic
acid,irinotecan and bevacizumab chemotherapy was started to
the patient at the forty day of the colon operation. The patient
was hospitalized after first administration of the 5th chemotherapy
cycle because of febrile neutropenia. Abdominal pain began
although the neutrophil count was within the normal ranges.
The patient was operated with the diagnosis of acute abdomen.
A one centimeter sized perforation was seen at the ilial
loop which was 80 cm proximal to the ileocaecal valve. The
patient died 8 days after the operation. Although bevacizumab
is generally a well-tolerated agent, one must pay attention.
Keywords: Bevacizumab; small intestine perforation; metastatic colon carcinoma
