Tokue Hiroyuki, Morita Hideo, Tokue Azusa, Tsushima Yoshito
Department of Diagnostic and Interventional Radiology, Gunma University Hospital, Maebashi, Japan.
SAGE Open Med Case Rep. 2017 Nov 11;5:2050313X17741014. doi: 10.1177/2050313X17741014. eCollection 2017.
Complications associated with intraductal papillary mucinous neoplasms, such as acute pancreatitis, perforation, and fistula formation, have been documented. Intraductal papillary mucinous neoplasm with intratumoral hemorrhage is rare. To the best of our knowledge, there have been no previous reports of intraductal papillary mucinous neoplasm rupture and bleeding with intra-abdominal hemorrhage. A 74-year-old woman complained of acute upper right abdominal pain. She was under follow-up for an intraductal papillary mucinous neoplasm in the pancreatic head. Contrast-enhanced computed tomography revealed intraductal papillary mucinous neoplasm rupture and bleeding with intra-abdominal hemorrhage. The bleeding was treated with selective endovascular embolization of a branch of the gastroduodenal artery. Follow-up examinations are recommended even for intraductal papillary mucinous neoplasm patients without malignant findings because of the potential risk of rupture and bleeding with intra-abdominal hemorrhage. Clinicians should be aware of this possibility to ensure that patients are appropriately treated.
与导管内乳头状黏液性肿瘤相关的并发症，如急性胰腺炎、穿孔和瘘管形成，已有文献记载。肿瘤内出血的导管内乳头状黏液性肿瘤很罕见。据我们所知，此前尚无导管内乳头状黏液性肿瘤破裂并伴有腹腔内出血的报道。一名74岁女性主诉右上腹急性疼痛。她因胰头导管内乳头状黏液性肿瘤正在接受随访。增强计算机断层扫描显示导管内乳头状黏液性肿瘤破裂并伴有腹腔内出血。通过对胃十二指肠动脉分支进行选择性血管内栓塞治疗出血。由于存在破裂并伴有腹腔内出血的潜在风险，即使是没有恶性表现的导管内乳头状黏液性肿瘤患者也建议进行随访检查。临床医生应意识到这种可能性，以确保患者得到适当治疗。
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