Department of Gastroenterology and Hepatology, Juntendo University Shizuoka Hospital, Japan.
Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Japan.
Intern Med. 2020 Sep 1;59(17):2135-2141. doi: 10.2169/internalmedicine.4372-19. Epub 2020 Jun 2.
Management of hemosuccus pancreaticus (HP) due to pancreatic adenocarcinoma is problematic. This is the first report of the successful management of HP caused by pancreatic adenocarcinoma by chemoradiotherapy, which is a treatment option for cases with a high surgical risk that are not suitable for interventional radiology. In the present case, bloody pancreatic juice was detected in the main pancreatic duct, and anemia worsened without repeated blood transfusions. The patient ultimately underwent chemoradiotherapy comprising radiation of 3 Gy in 15 fractions concomitant with systemic chemotherapy of S-1. After the treatments, the anemia improved, and the patient was discharged on day 45.
由于胰腺腺癌导致的胰血瘘(HP)的处理存在问题。这是首例通过放化疗成功治疗胰腺腺癌导致的 HP 的报告,为那些手术风险高、不适合介入放射治疗的病例提供了一种治疗选择。在本病例中,主胰管中检测到血性胰液,且贫血加重,未反复输血。最终,该患者接受了包括 3 Gy 分 15 次照射的放射治疗,并同时进行 S-1 全身化疗。治疗后,贫血得到改善,患者于第 45 天出院。