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Papers of the Week

2020 Feb 20

BMJ Case Rep



Case of small bowel perforation secondary to nivolumab and ipilimumab related tumour regression.


Patel K R, Lee L Y, Tripathy A, McKean D
BMJ Case Rep. 2020 Feb 20; 13(2).
PMID: 32086324.


A 56-year-old man undergoing immunotherapy treatment for metastatic melanoma presented with sudden onset testicular pain radiating into his abdomen. On examination, the abdomen was generally tender with associated guarding. Imaging revealed a perforation of the small bowel at the site of a metastatic lesion. Histology revealed that this process was non-inflammatory in nature. A diagnosis of small bowel perforation secondary to immunotherapy driven rapid tumour regression was made. The patient was treated with a small bowel resection plus anastomosis and made a full recovery. This case highlights the rare potential side effect of immunotherapy in causing non-inflammatory bowel perforations secondary to rapid tumour regression.