title: Diagnosis and management of pancreatic carcinoma during pregnancy.
abstract: BACKGROUND
  Acute, persistent abdominal pain due to ruptured pancreatic carcinoma and perforated stomach is extremely rare during pregnancy.
  
  
  METHODS
  We evaluated a woman at 34 weeks of gestation presenting with uterine contractions. Computed tomography scanning revealed a large retroperitoneal mass, and her blood carbohydrate antigen 19-9 level was elevated. Immediately after an emergency cesarean delivery, pancreatic cancer was detected, and pancreatoduodenectomy was performed. The patient underwent chemotherapy and remains disease-free at 2 years.
  
  
  CONCLUSIONS
  Delayed diagnosis and treatment are associated with high morbidity of both neonate and mother in cases of pancreatic cancer during pregnancy. Computed tomography scanning and carbohydrate antigen 19-9 levels are useful for diagnosis, after which radical surgery should be performed immediately in late pregnancy.
authors.affiliation: From the Department of Obstetrics and Gynecology, Fukui Aiiku Hospital, Fukui-city, Japan; and the Department of Obstetrics and Gynecology, Fukui University Hospital, Eiheiji-tyou, Japan.
authors.forename: Toshimichi
authors.initials: T
authors.lastname: Onuma
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Yoshida
authors.forename: Takara
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Fumikazu
authors.initials: F
authors.lastname: Kotsuji
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D000328:Adult; D018395:CA-19-9 Antigen / Q000097:blood; D002585:Cesarean Section; D005260:Female; D006801:Humans; D010190:Pancreatic Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis* / Q000601:surgery*; D012422:Rupture, Spontaneous; D013272:Stomach Diseases / Q000209:etiology / Q000601:surgery; D014057:Tomography, X-Ray Computed
chemical_list: D018395:CA-19-9 Antigen