Üst
gastrointestinal sistem kanamasinin nadir sebebi:
Villöz adenom zemininde gelismis duodenal adenokarsinom
Rare cause of upper gastrointestinal bleeding: Primer adenocarcinoma of the duodenum arising from villous adenoma
- Ana Sayfa
- Sayılar
- Üst
gastrointestinal sistem kanamasinin nadir sebebi:
Villöz adenom zemininde gelismis duodenal adenokarsinom...
Özet
Primer duodenal adenokarsinomlar tüm gastrointestinal malinitelerin %0.5’lik kismini olusturur. Bu tümörler gizli kan kaybi ve kendi kendini sinirlayan kanamayla karakterlidir. Biz tekrarlayan, klinik olarak anlamli gastrointestinal kanamaya neden olan duodenal adenokarsinom olgusunu rapor ettik. Olgu: 59 yasindaki erkek hasta 1 aydir tekrarlayan melena yakinmasiyla yatirildi. Öyküde 1,5 ayda 8 kg kayip ve fizik incelemede anemi bulgulari mevcuttu. Laboratuvar incelemede Hb: 7.5 gr/dl, MCV: 69 sedimentasyon: 6 mm/h olarak saptandi. Endoskopide, bulbusun ön duvari ve duodenum 2. kismini içine alan aktif kanamali ülserovejetan kitle lezyonu gözlendi. Kanamanin devam etmesi nedeniyle cerrahiye devredilen hastaya Whipple operasyonu uygulandi. Patolojik inceleme sonucu evre III villöz adenomdan kaynaklanan primer duodenal adenokarsinom tespit edildi.
Abstract
Duodenal adenocarcinomas account for 0.5% of all gastrointestinal malignancies. These malignancies are generally characterized by blood loss and self-limited bleeding. We report adenocarcinoma of the duodenum causing recurrent, clinically significant bleeding. Case: A 59-year-old male was admitted to hospital with recurrent melena. History revealed an 8 kg weight loss in 1.5 months, and signs of anemia were observed on physical examination. Hb: 7.5 g/dl, MCV: 69.7, and sedimentation rate of 6 mm/h were detected in laboratory examination. An actively bleeding, ulcero-vegetan mass involving the anterior wall of the bulbus and second part of the duodenum was observed in endoscopy. Since active bleeding continued, Whipple operation was applied in the Surgery Department. Pathologic examination of the surgical samples showed stage III, primary adenocarcinoma of the duodenum arising from villous adenoma
