Duodenal Hemorrhage Due to an Invasive Hepatocellular Carcinoma Controlled by Transarterial Embolization.
chemotherapy
gastro-intestinal bleeding
hepatocellular carcinoma
hepatoduodenal fistula
immunotherapy
transarterial embolization
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
Nov 2022
Nov 2022
Historique:
accepted:
30
11
2022
entrez:
5
1
2023
pubmed:
6
1
2023
medline:
6
1
2023
Statut:
epublish
Résumé
Upper gastrointestinal (GI) bleeding due to duodenal invasion is a very unusual presentation revealing the initial diagnosis of hepatocellular carcinoma (HCC), especially in patients without cirrhosis. No clear recommendations are available in this setting. A 68-year-old man was admitted to the emergency department with melena. The esophagogastroduodenoscopy (EGD) revealed an oozing hemorrhagic ulcer of the duodenal bulb (Forrest I b) secondary to an invasive, undetermined bulky liver mass that was biopsied. The histopathological examination confirmed an HCC. The patient was started on chemotherapy (Gemcitabine and Oxaliplatin) with good initial response. Nevertheless, after eight months of treatment, there was a recurrence of the ulcer bleeding and a disease progression was identified. Selective transarterial embolization (TAE) was used to control the duodenal bleeding, permitting the patient to receive immunotherapy with a long-lasting control of the disease. Our case report suggests that selective TAE is a therapeutic option that can be used to stop GI bleeding due to invasive HCC in order to allow oncological treatment.
Identifiants
pubmed: 36600825
doi: 10.7759/cureus.32046
pmc: PMC9800851
doi:
Types de publication
Case Reports
Langues
eng
Pagination
e32046Informations de copyright
Copyright © 2022, Deforche et al.
Déclaration de conflit d'intérêts
The authors have declared financial relationships, which are detailed in the next section.
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