CICATRICIAL JEJUNAL STENOSIS AFTER CHEMOT HERAPY FOR A GASTROINTESTINAL LYMPHOMA

History and clinical findings: 4 weeks after completing a course of ch emotherapy for non-Hodgkin lymphoma of the jejunum a 45-year-old woman developed pain in the left upper abdomen and postprandial vomiting so that she could no longer take food by mouth. Investigations: On admis sion she looked cachectic and had obviously lost weight. Plain abdomin al X-ray gave no evidence of perforation or ileus. Gastroduodenoscopy showed no local recurrence. But contrast jejunal radiography (after Se llink) demonstrated two severe band-like stenoses of the jejunum with prestenotic dilatation. As she had not had any previous operation oi r adiotherapy, cicatricial stenosis was considered as the most likely ca use. As the symptoms continued and stenosing local recurrence could no t be excluded, surgical resection was indicated. Treatment and course: Two cicatricial intramural stenoses of the proximal jejunum were foun d and histologically confirmed without evidence of lymphoma recurrence . After the operation the patient was again able to take food by mouth without problem. Follow-up examination 8 months later showed no recur rence and she was free of gastrointestinal symptoms. Conclusion: After chemotherapy for gastrointestinal lymphoma obstruction of the small i ntestine may occur due to chemotherapy-induced scarring.