Pneumatosis intestinalis induced by targeted therapy.

A middle aged woman presented to the emergency department with vomiting and diarrhoea for 5 days. She was diagnosed as stage IV lung adenocarcinoma with EGFR mutation. Two weeks ago, she just started a combination of erlotinib and crizotinib based on the discovery of MET amplification after failure of afatinib and subsequent chemotherapy treatment. At the emergency department, she appeared with acute ill-looking, low-grade fever (37.6°C), hypotension (SBP/DBP 87/57 mm Hg) and tachycardia (140 bpm). Physical examination showed a soft and mildly distended abdomen with hypoactive bowel sounds and no tenderness or rebounding pain. Laboratory tests revealed elevated C reactive protein (14.54 mg/dL) and lactate …