Intestinal perforation secondary to paclitaxel.

Three patients with colonic perforation following paclitaxel therapy are reported. This appears to be a direct drug effect causing mitotic arrest on the gastrointestinal epithelium. Eleven such patients with this complication have now been identified. While infrequent, this is a serious complication with a 57% mortality rate. The exact incidence of this complication is unknown and may have been previously underreported being attributed to progressive disease. A high index of suspicion of this complication should be considered for anyone presenting with abdominal pain following paclitaxel.