title: [Two Cases Pancreatic Carcinoma Detected Incidentally during Treatment of Acute Abdomen from Other Causes].
abstract: We report 2 cases of pancreatic cancer discovered incidentally in the wake of acute abdomen from other causes. Case 1 is a 67-year-old man who was referred to our hospital in October 2010 for the treatment of an incarcerated right inguinal hernia. The hernia was manually reduced, and mesh plug hernioplasty was scheduled for the next day. A 2.9 cm diameter tumor was detected in the tail of the pancreas on plain CT at the first visit and confirmed on enhanced CT soon after the hernia repair. A follow-up abdominal CT scan approximately 1 month later showed modest enlargement of the tumor to 3.5 cm diameter. The patient underwent distal pancreatectomy with lymph node dissection in December 2010. The histopathological diagnosis was tubular adenocarcinoma(tub1>tub2). Comprehensive findings were pT2, pN0, cM0, fStage II . He was treated with adjuvant chemotherapy consisting of gemcitabine 1,000mg/m2 for 6 months after surgery, and at 5 years and 7 months after surgery, he was alive and recurrence-free. Case 2 is a 74-year-old man who presented to our hospital with lower abdominal pain and diarrhea in early January 2016. Colonoscopy and barium enema revealed severe stenosis of the rectum(Rs). Rectal biopsy confirmed adenocarcinoma of the rectum. In addition, an enhanced CT scan showed irregular dilatation of the pancreatic duct in the pancreatic tail. The patient underwent low anterior resection and distal pancreatectomy, which was performed following an intraoperative pancreatic ultrasound examination that supported a diagnosis of pancreatic cancer. Pathological and comprehensive findings of rectal cancer were tubular adenocarcinoma(tub2)and pT3, pN0, cM0, fStage II , and those of the pancreatic cancer were tubular adenocarcinoma(tub2)and pT1, pN0, cM0, fStage I . The patient was discharged from the hospital 46 days after surgery. However, he died 18 days later due to sudden out-of-hospital cardiopulmonary arrest.
authors.affiliation: Dept. of Surgery, Fujisaki Hospital.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Fujisaki
authors.forename: Motoi
authors.initials: M
authors.lastname: Takashina
authors.forename: Ryouichi
authors.initials: R
authors.lastname: Tomita
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sakurai
authors.forename: Tadatoshi
authors.initials: T
authors.lastname: Takayama
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology*; D000230:Adenocarcinoma; D000368:Aged; D001706:Biopsy; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome