Department of Hepatobiliary Surgery, Xinqiao Hospital, Third Military Medical University, Xinqiao Street, Chongqing 400037, China.
World J Surg Oncol. 2012 Sep 25;10:199. doi: 10.1186/1477-7819-10-199.
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.
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.
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.
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.
由肾细胞癌引起的十二指肠转移导致胃肠道出血极为罕见。先前的几份报告表明，栓塞治疗或胰十二指肠切除术（根治性手术切除）可能对控制这种类型的临床并发症有效。其治疗方法完全取决于一般情况和其他部位的并发转移。因此，优化治疗策略值得进一步讨论和探索。
在本报告中，我们描述了一位患有严重合并症的患者，他成功地接受了姑息性十二指肠楔形切除术和直接十二指肠壁缺损修复术，而无需进行胆肠吻合术重建，以治疗因肾透明细胞癌引起的十二指肠转移导致的急性上消化道出血。
患者术后恢复顺利，未出现再出血和频繁呕吐。此后（1.5 年），他未再出现出血迹象。
即使存在严重的合并症，对于姑息治疗，由 RCC 引起的胃肠道出血也可能受益于紧急切除。
