title: A case of wedge resection of duodenum for massive gastrointestinal bleeding due to duodenal metastasis by renal cell carcinoma.
abstract: BACKGROUND
  Gastrointestinal bleeding due to duodenal metastasis from renal cell carcinoma is extremely rare. Several previous reports have shown that embolic therapy or pancreatoduodenectomy (radical surgical resection) could be effective in controlling this type of clinical complication. Management is entirely dependent on the general condition and concurrent metastases at other sites. Optimizing the therapeutic strategies thus deserves further discussion and exploration.
  
  
  METHODS
  In this report, we describe a patient with severe co-morbidities who underwent successful palliative wedge resection of duodenum and direct duodenal wall defect repair without reconstruction of duodeno-jejunostomy for acute upper digestive tract hemorrhage caused by duodenal metastasis from renal clear cell carcinoma.
  
  
  RESULTS
  The patient recovered uneventfully and did not experience rebleeding and frequent vomiting after surgery. Since then (1.5 years) he has had no evidence of rebleeding.
  
  
  CONCLUSIONS
  Gastrointestinal bleeding due to duodenal metastasis of RCC may benefit from emergent resection even in the presence of severe co-morbidities, and for palliative treatment.
authors.affiliation: Department of Hepatobiliary Surgery, Xinqiao Hospital, Third Military Medical University, Xinqiao Street, Chongqing 400037, China.
authors.forename: Hongzhi
authors.initials: H
authors.lastname: Zhao
authors.forename: Keqiang
authors.initials: K
authors.lastname: Han
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.forename: Ping
authors.initials: P
authors.lastname: Liang
authors.forename: Guohua
authors.initials: G
authors.lastname: Zuo
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhang
authors.forename: Hongyan
authors.initials: H
authors.lastname: Li
mesh_terms: D002292:Carcinoma, Renal Cell / Q000473:pathology*; D004379:Duodenal Neoplasms / Q000473:pathology / Q000556:secondary*; D004386:Duodenum / Q000473:pathology / Q000601:surgery*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged