Research
A case of wedge resection of duodenum for massive gastrointestinal bleeding due to duodenal metastasis by renal cell carcinoma
1 Department of Hepatobiliary Surgery, Xinqiao Hospital, Third Military Medical University, Xinqiao Street, Chongqing 400037, China
2 Division of Immunology &Inflammation, Department of Medicine, Imperial College, Hammersmith Campus, Du Cane Road, London, W12 0NN, UK
World Journal of Surgical Oncology 2012, 10:199 doi:10.1186/1477-7819-10-199
Published: 25 September 2012Abstract
Background
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.
Methods
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.
Results
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.
Conclusions
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.
