Gastric Ulceration in Patients Receiving Intrahepatic Infusion of 5-Fluorouracil

Abstract

Gastric ulceration developed in 8 patients during inrahepatic arterial infusion of 5-FU [5-fluorouracil] for liver metastases. Bleeding occurred in 4 instances and perforation in 1. In all cases the catheter tip was dislodged and was proximal to its correct position, allowing the stomach to be directly infused with 5-FU. No duodenal ulcers were noted. All patients were symptomatic for several days before the diagnosis was made. Of 20 patients with catheter dislodgement, 5 had documented ulcers, 3 had upper gastrointestinal bleeding of undetermined etiology, 8 had epigastric pain or vomiting and only 4 were asymptomatic. Prompt determination of catheter position is necessary in patients receiving intrahepatic arterial infusion of 5-FU if symptoms consistent with gastric ulceration occur. Gastric ulcers should be vigorously treated because of the high rate of complications in patients receiving chemotherapy.