{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T14:01:48Z","timestamp":1788184908474,"version":"build-2803163510"},"reference-count":14,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,11,28]]},"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:p>Acute gastrointestinal (GI) immune-related adverse events (irAE) are commonly reported by patients with cancer undergoing treatment with immune checkpoint inhibitors (CPI); however chronic irAEs are rare. We present a case of a 71-year-old woman with metastatic gastro-oesophageal junction (GOJ) adenocarcinoma who developed delayed-onset chronic intestinal pseudo-obstruction (CIPO) while receiving second-line pembrolizumab. Repeated CT scans of the abdomen\/pelvis found no small bowel obstruction, and evaluations for bowel inflammation, infection and paraneoplastic syndrome were negative. Bowel rest and glucocorticoids were associated with transient symptom resolution; however, symptoms recurred within 1\u2009month. The patient was ultimately supported with total parenteral nutrition and intestinal motility agents. After 4\u2009months, the GOJ cancer remained stable with no signs of progression. As CPI use expands, the incidence of rare irAEs, such as CIPO, may increase.<\/jats:p>","DOI":"10.1136\/bcr-2019-232388","type":"journal-article","created":{"date-parts":[[2019,12,16]],"date-time":"2019-12-16T05:20:28Z","timestamp":1576473628000},"page":"e232388","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Chronic intestinal pseudo-obstruction in a patient with metastatic gastro-oesophageal junction cancer receiving treatment with pembrolizumab"],"prefix":"10.1136","volume":"12","author":[{"given":"Robert J","family":"Besaw","sequence":"first","affiliation":[{"name":"Internal Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin P","family":"Smith","sequence":"additional","affiliation":[{"name":"Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica A","family":"Zerillo","sequence":"additional","affiliation":[{"name":"Internal Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea J","family":"Bullock","sequence":"additional","affiliation":[{"name":"Internal Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,12,15]]},"reference":[{"key":"2025082713241781000_12.12.e232388.1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21492"},{"key":"2025082713241781000_12.12.e232388.2","doi-asserted-by":"crossref","unstructured":"De Martel C , Parsonnet J . Stomach cancer. In: Thun M , Linet MS , Cerhan JR , eds. Schottenfeld and fraumeni cancer epidemiology and prevention. 4th edn. 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