title: Palliative segmental duodenectomy for bleeding, erosive endometrial cancer.
abstract: BACKGROUND
  Endometrial cancer is the fourth most common malignancy among women. Metastases typically involve the lungs, peritoneal surfaces of the abdominal cavity, and lymph nodes outside the pelvis.
  
  
  METHODS
  We report an unusually difficult complication of metastatic endometrial cancer occurring in a 57 year-old woman with paraaortic nodal recurrence: refractory occult gastrointestinal bleeding. Repeated upper endoscopic evaluation revealed an extrinsic mass eroding into the third portion of the duodenum. Segmental duodenal resection was performed, and the GI tract was reconstructed with a side-to-side duodenojejunostomy. The postoperative course was uneventful, and the patient experienced durable relief from continued bleeding and impending obstruction.
  
  
  CONCLUSIONS
  We review the role of palliative surgery for bleeding complications of advanced cancer and the alternatives for treating invasive extrinsic lesions of the duodenum.
authors.affiliation: Department of Surgery, Division of Surgical Oncology, University of Pittsburgh School of Medicine, 497 Scaife Hall, Pittsburgh, PA 15261, USA.
authors.forename: James J
authors.initials: JJ
authors.lastname: Schneider
authors.forename: Sahir
authors.initials: S
authors.lastname: Shroff
authors.forename: A James
authors.initials: AJ
authors.lastname: Moser
mesh_terms: D013505:Digestive System Surgical Procedures / Q000379:methods; D004379:Duodenal Neoplasms / Q000556:secondary / Q000601:surgery*; D004386:Duodenum / Q000601:surgery*; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*