Hematemesis as the initial complication of pancreatic adenocarcinoma directly invading the duodenum: a case report.
Pancreatic carcinoma is a debilitating disease and carries a poor prognosis. It is a rare cause of upper gastrointestinal bleeding, even though pancreas, stomach, duodenum and jejunum are adjacent organs. The incidence of pancreatic adenocarcinoma directly invading the gastrointestinal tract leading to gastrointestinal hemorrhage is very low, and most of them present with melena and hematochezia. Here, we describe one unique case manifesting characteristically severe and unremitting hematemesis as an initial presentation of pancreatic adenocarcinoma. This tumor directly invaded the duodenal mucosa as a bleeding protruding tumor mass. Our MEDLINE search has confirmed that this is the first reported case with an initial manifestation of hematemesis from pancreatic adenocarcinoma in Asians. Pancreatic adenocarcinoma directly invading duodenum complicated by hemorrhage can be a rare cause of hematemesis, and clinicians should be reminded of it while they are making differential diagnosis.
Lin
Yueh-Hung
YH
Division of Gastroenterology, Taipei Veterans General Hospital, 12F, 201, Sec. 2, Shih-Pai Road, Taipei 112, Taiwan, China.
Chen
Chih-Yen
CY
Chen
Chih-Ping
CP
Kuo
Tien-Yin
TY
Chang
Full-Young
FY
Lee
Shou-Dong
SD
D000230:Adenocarcinoma / Q000150:complications* / Q000473:pathology; D000368:Aged; D004386:Duodenum / Q000473:pathology*; D006396:Hematemesis / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male; D009361:Neoplasm Invasiveness; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000473:pathology; D014057:Tomography, X-Ray Computed