Case Report
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 7, 2005; 11(5): 767-769
Published online Feb 7, 2005. doi: 10.3748/wjg.v11.i5.767
Hematemesis as the initial complication of pancreatic adenocarcinoma directly invading the duodenum: A case report
Yueh-Hung Lin, Chih-Yen Chen, Chih-Ping Chen, Tien-Yin Kuo, Full-Young Chang, Shou-Dong Lee
Yueh-Hung Lin, Chih-Yen Chen, Tien-Yin Kuo, Full-Young Chang, Shou-Dong Lee, Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital and School of Medicine, National Yang-Ming University, Taipei, Taiwan
Chih-Ping Chen, Department of Health, Tao-Yuan General Hospital Tao-Yuan, Taiwan
Author contributions: All authors contributed equally to the work.
Correspondence to: Chih-Yen Chen, M.D., Division of Gastroenterology, Taipei Veterans General Hospital, 12F, 201, Sec. 2, Shih-Pai Road, Taipei 112, Taiwan. chency@vghtpe.gov.tw
Telephone: +886-2-28757308 Fax: +886-2-28711058
Received: May 25, 2004
Revised: May 29, 2004
Accepted: June 29, 2004
Published online: February 7, 2005
Abstract

Pancreatic carcinoma is a debilitating disease and carries a poor prognosis. It is a rare cause of upper gastrointestinal bleeding, even though pancreas, stomach, duodenum and jejunum are adjacent organs. The incidence of pancreatic adenocarcinoma directly invading the gastrointestinal tract leading to gastrointestinal hemorrhage is very low, and most of them present with melena and hematochezia. Here, we describe one unique case manifesting characteristically severe and unremitting hematemesis as an initial presentation of pancreatic adenocarcinoma. This tumor directly invaded the duodenal mucosa as a bleeding protruding tumor mass. Our MEDLINE search has confirmed that this is the first reported case with an initial manifestation of hematemesis from pancreatic adenocarcinoma in Asians. Pancreatic adenocarcinoma directly invading duodenum complicated by hemorrhage can be a rare cause of hematemesis, and clinicians should be reminded of it while they are making differential diagnosis.

Keywords: Pancreatic adenocarcinoma; Duodenum tumor; Hematemesis; Neoplasm invasiveness