Intestinal Pseudo-Obstruction After Vincristine Use. Cureus A 73-year-old man presented with nausea, abdominal discomfort, and distention persisting for the past five days. He had previously been diagnosed with stage III peripheral CD4+ T cell lymphoma and had initiated chemotherapy comprising vincristine two weeks prior to presentation. An evaluation revealed diffuse colon distention and pneumatosis intestinalis without mechanical obstruction, consistent with acute colonic pseudo-obstruction. The patient underwent surgical intervention and was subsequently admitted to the Intensive Care Unit due to distributive shock. Vincristine-induced ileus followed by intestinal pseudo-obstruction was suspected to be the underlying cause after excluding alternative causative factors. 10.7759/cureus.74213

Preclinical evaluation of the effects on the gastrointestinal tract of the antineoplastic drug vincristine repeatedly administered to rats. López-Gómez L,Díaz-Ruano S,Girón R,López-Pérez A E,Vera G,Herradón Pliego E,López-Miranda V,Nurgali K,Martín-Fontelles M I,Uranga J A,Abalo R Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society BACKGROUND:Vincristine is a commonly used chemotherapeutic agent. It is associated with undesirable digestive side effects. However, the impact of vincristine on gastrointestinal structure and motility or its long-term effects have not been deeply studied in animal models. This could be useful in order to develop therapeutic or preventive strategies for cancer patients. The aim of this study was to analyze such effects. METHODS:Rats received saline or vincristine (0.1 mg kg , ip) daily for 10 days. Evaluations were performed during treatment and 2-6 weeks after. Somatic mechano-sensitivity was assessed using von Frey hairs. Gastrointestinal motor function was studied by means of radiographic still images and colonic propulsion of fecal pellets using fluoroscopy videos. Histological assessment of the gut morphology and immunohistochemistry for HuC/D and nNOS were performed in whole-mount myenteric plexus preparations. KEY RESULTS:Peripheral sensitivity was increased in animals treated with vincristine and did not subside 2 weeks after treatment finalization. Vincristine treatment inhibited gastrointestinal motility although this was recovered to normal values with time. Damage in the digestive wall after vincristine treatment was greater in the ileum than in the colon. Villi shortening (in ileum) and large inflammatory nodules still remained 2 weeks after treatment finalization. Finally, the proportion of nNOS-immunoreactive neurons was increased with vincristine and continued to be increased 2 weeks after treatment finalization. CONCLUSIONS AND INFERENCES:Vincristine alters gastrointestinal motility, peripheral sensitivity and mucosal architecture. Vincristine-induced neuropathy (somatic and enteric), intestinal mucosa damage and inflammatory infiltrations are relatively long-lasting. 10.1111/nmo.13399