We report three cases of terminal-stage ovarian cancer where diatrizoate meglumine and diatrizoate sodium solution (Gastrografin) was effective for malignant bowel obstruction due to peritoneal dissemination. All cases had gastrointestinal symptoms such as nausea, vomiting, abdominal pain, and constipation, showed air-fluid levels and dilation of the small intestine on imaging tests. Therefore, all the cases were diagnosed as bowel obstruction. We initiated oral administration of Gastrografin because the patients failed to show a sufficient response to other drugs such as octreotide. Their gastrointestinal symptoms such as nausea and constipation improved after administration of the drug, and they could continue oral intake. In addition, they were diagnosed as having an incomplete bowel obstruction since radiographic examination 24 hours after administration of Gastrografin confirmed its presence in the large intestine. In all the cases, Gastrografin could be used repeatedly without noticeable side effects. This study suggests that Gastrografin might be useful for evaluating bowel obstruction and improving gastrointestinal symptoms in patients with malignant bowel obstruction caused by terminal-stage ovarian cancer.

Case: A 71-year-old woman with diabetes mellitus was diagnosed as end-stage ovarian cancer. She was suffering from stomachache and anorexia because of massive ascites. Although we performed abdominal paracentesis for symptomatic palliation, ascites accumulated again in a few days. In order to control the refractory ascites, we administered intraperitoneal triamcinolone acetonide (10 mg/kg) after the fourth abdominal paracentesis; consequently, the interval between the consecutive abdominal paracentesis procedures was extended remarkably. However, prolonged hyperglycemia occurred despite the administration of a single dose of triamcinolone acetonide, and insulin therapy was required for eight days. Conclusion: To our knowledge, this is the first report of intraperitoneal administration of triamcinolone acetonide that caused prolonged hyperglycemia. Therefore, this drug should be administered with caution in such patients with diabetes mellitus.