Successful Management of Hemosuccus Pancreaticus due to Pancreatic Adenocarcinoma by Chemoradiotherapy

Ko Tomishima; Toshio Fujisawa; Sho Sato; Nozomi Amano; Ayato Murata; Hironori Tsuzura; Shunsuke Sato; Kouhei Matsumoto; Yuji Shimada; Ryo Wada; Takuya Genda; Hiroyuki Isayama

doi:10.2169/internalmedicine.4372-19

CASE REPORTS

Successful Management of Hemosuccus Pancreaticus due to Pancreatic Adenocarcinoma by Chemoradiotherapy

Ko Tomishima, Toshio Fujisawa, Sho Sato, Nozomi Amano, Ayato Murata, Hironori Tsuzura, Shunsuke Sato, Kouhei Matsumoto, Yuji Shimada, Ryo Wada, Takuya Genda, Hiroyuki Isayama

Author information

Ko Tomishima
Department of Gastroenterology and Hepatology, Juntendo University Shizuoka Hospital, Japan
Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Japan
Toshio Fujisawa
Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Japan
Sho Sato
Department of Gastroenterology and Hepatology, Juntendo University Shizuoka Hospital, Japan
Nozomi Amano
Department of Gastroenterology and Hepatology, Juntendo University Shizuoka Hospital, Japan
Ayato Murata
Department of Gastroenterology and Hepatology, Juntendo University Shizuoka Hospital, Japan
Hironori Tsuzura
Department of Gastroenterology and Hepatology, Juntendo University Shizuoka Hospital, Japan
Shunsuke Sato
Department of Gastroenterology and Hepatology, Juntendo University Shizuoka Hospital, Japan
Kouhei Matsumoto
Department of Gastroenterology and Hepatology, Juntendo University Shizuoka Hospital, Japan
Yuji Shimada
Department of Gastroenterology and Hepatology, Juntendo University Shizuoka Hospital, Japan
Ryo Wada
Department of Pathology, Juntendo University Shizuoka Hospital, Japan
Takuya Genda
Department of Gastroenterology and Hepatology, Juntendo University Shizuoka Hospital, Japan
Hiroyuki Isayama
Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Japan

Keywords: pancreatic cancer, chemoradiotherapy, hemosuccus pancreaticus, bleeding

JOURNAL OPEN ACCESS

2020 Volume 59 Issue 17 Pages 2135-2141

DOI https://doi.org/10.2169/internalmedicine.4372-19

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Details

Abstract

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.

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