2022 Volume 37 Issue 2 Pages 87-95
A 61-year-old male was referred with the sudden onset of abdominal fullness for further examination and treatment. Enhanced computed tomography scan revealed a multi-cystic lesion from the pancreas tail to the spleen, with extravasation of contrast medium to the intraabdominal space. Emergent angiography with embolization of the extravasating artery was performed. Instead of hemostasis only by embolization, we considered that there was a high risk of rebleeding. Thus, we planned surgery to establish complete hemostasis 3 days after embolization. Distal pancreatectomy with lymph node dissection was performed. In addition, concomitant resection of the left transverse colon was needed due to involvement of the tumor. Pathological diagnosis revealed anaplastic carcinoma of the pancreas with invasion to the transverse colon and spleen. Rapid growth of the tumor caused rupture of the tumor with intraabdominal hemorrhage as the presenting symptom. Anaplastic carcinoma of the pancreas presenting with intraabdominal hemorrhage is rare. This mechanism is reasonable due to the rapid and aggressive growth of anaplastic carcinoma. Prompt planning of a treatment strategy is needed in the treatment of patients with intraabdominal bleeding.
