Yasumoto Taku, Yamamoto Takuma, Tomimaru Yoshito, Ide Yoshihito, Matsunaga Hiroki, Ikeda Nobuko, Maruyama Kentarou, Yokouchi Hideoki, Okada Kazuyuki, Ota Hideo, Kinuta Masakatsu, Murata Kouhei
Dept. of Radiology, Suita Municipal Hospital.
Gan To Kagaku Ryoho. 2007 Nov;34(12):2141-3.
We report a case of duodenal carcinoma with continuous bleeding that was successfully treated with transcatheter arterial embolization using gelatin sponge particles. The case was a woman in her 70's who had a curative surgical resection for sigmoid colon cancer with liver and lung metastases, hepatic arterial infusion chemotherapy and radiofrequency ablation for liver metastasis in the past. She was admitted to our hospital because of liver abscess and anemia. Upper gastrointestinal endoscopy revealed active bleeding from a duodenal tumor. The biopsy of the specimens was made and showed duodenal adenocarcinoma. The patient was considered to be inoperable because of the liver abscess and transcatheter arterial embolization of an anterior superior pancreaticoduodenal artery through an inferior pancreaticoduodenal artery was performed for the continuous bleeding from duodenal carcinoma not completely treated by endoscopic hemostasis or frequent transfusion. After the tumor embolization anemia was improved and partial response was obtained by systemic chemotherapy of mFOLFOX6. Transcatheter arterial embolization for a continuous bleeding from duodenal carcinoma is a feasible and effective method as a noninvasive therapy when it is unabled to be treated by surgical resection or endoscopic therapy.
我们报告一例十二指肠癌伴持续出血,通过使用明胶海绵颗粒经导管动脉栓塞术成功治疗。该病例为一名70多岁的女性,既往曾因乙状结肠癌伴肝肺转移接受根治性手术切除,因肝转移接受肝动脉灌注化疗及射频消融治疗。她因肝脓肿和贫血入住我院。上消化道内镜检查显示十二指肠肿瘤有活动性出血。对标本进行活检,结果显示为十二指肠腺癌。由于肝脓肿,该患者被认为无法进行手术,遂通过胰十二指肠下动脉对胰十二指肠上前动脉进行经导管动脉栓塞术,以治疗经内镜止血或频繁输血仍未完全控制的十二指肠癌持续出血。肿瘤栓塞后,贫血得到改善,通过mFOLFOX6全身化疗获得部分缓解。当十二指肠癌持续出血无法通过手术切除或内镜治疗时,经导管动脉栓塞术作为一种非侵入性治疗方法是可行且有效的。