scholarly journals Multicenter randomized phase II trial of prophylactic right‐half dissection of superior mesenteric artery nerve plexus in pancreatoduodenectomy for pancreatic head cancer

2020 ◽  
Author(s):  
Suguru Yamada ◽  
Sohei Satoi ◽  
Hideki Takami ◽  
Tomohisa Yamamoto ◽  
Isaku Yoshioka ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Phase Ii ◽  
Mesenteric Artery ◽  
Phase Ii Trial ◽  
Pancreatic Head ◽  
Nerve Plexus ◽  
Head Cancer ◽  
Pancreatic Head Cancer ◽  
Randomized Phase Ii

scholarly journals Lethal Bleeding from a Duodenal Cancerous Ulcer Communicating with the Superior Mesenteric Artery in a Patient with Pancreatic Head Cancer

2018 ◽  
Vol 12 (2) ◽  
pp. 479-486
Author(s):  
Yoshifumi Morita ◽  
Takanori Sakaguchi ◽  
Ryo Kitajima ◽  
Satoru Furuhashi ◽  
Ryota Kiuchi ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Pancreatic Head ◽  
Severe Bleeding ◽  
Main Trunk ◽  
Head Cancer ◽  
Pancreatic Head Cancer ◽  
Aortic Balloon Occlusion ◽  
Duodenal Bleeding

Pancreatic cancer often invades the duodenum and causes obstruction, but rarely causes massive duodenal bleeding. A 68-year-old male was admitted to our hospital because of vomiting. Enhanced abdominal CT showed a hypovascular tumor with air bubbles in the uncinate process of the pancreas. The tumor invaded the duodenum and metastasized to the liver and peritoneum. The main trunk of the superior mesenteric artery (SMA) was circumferentially involved. After admission, he had hematemesis and melena. Emergency gastroduodenoscopy revealed pulsating vessels in the third portion of the duodenum and he eventually experienced hemorrhagic shock. Severe bleeding occurred from his mouth and anus like a catastrophic flood. It was difficult to sustain blood pressure even with massive blood transfusion with pumping. After insertion of an intra-aortic balloon occlusion catheter, the massive bleeding was eventually stopped. Although we attempted interventional radiography, aortography revealed direct communication between the main SMA trunk and the duodenal lumen. The tumor was considered anatomically and oncologically unresectable. Thus, we did not perform further intervention. The patient died 2 h after angiography. Herein, we report the case of pancreatic head cancer causing lethal bleeding associated with tumor-involved SMA. Duodenal bleeding associated with pancreatic cancer invasion should be considered as an oncogenic emergency.

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