Postoperative delayed massive bleeding in gastric cancer: a case report.
Humans
Female
Stomach Neoplasms
/ surgery
Middle Aged
Gastrectomy
Postoperative Hemorrhage
/ etiology
Angiography, Digital Subtraction
Embolization, Therapeutic
Aneurysm, False
/ diagnostic imaging
Aorta, Abdominal
/ diagnostic imaging
Tomography, X-Ray Computed
Hematemesis
/ etiology
Duodenum
/ blood supply
Treatment Outcome
Case report
Gastric malignancy
Hemorrhage
Postoperative complications
Surgical interventions
Journal
Journal of medical case reports
ISSN: 1752-1947
Titre abrégé: J Med Case Rep
Pays: England
ID NLM: 101293382
Informations de publication
Date de publication:
25 Apr 2024
25 Apr 2024
Historique:
received:
13
01
2024
accepted:
22
03
2024
medline:
25
4
2024
pubmed:
25
4
2024
entrez:
24
4
2024
Statut:
epublish
Résumé
Postoperative delayed bleeding of gastric cancer is a complication of radical gastrectomy with low incidence rate and high mortality. This case report presents the case of a 63-year-old female patient of Mongolian ethnicity who was diagnosed with gastric malignancy during a routine medical examination and underwent Billroth's I gastric resection in our department. However, on the 24th day after the surgery, she was readmitted due to sudden onset of hematemesis. Gastroscopy, abdominal CT, and digital subtraction angiography revealed postoperative anastomotic fistula, rupture of the duodenal artery, and bleeding from the abdominal aorta. The patient underwent three surgical interventions and two arterial embolizations. The patient's condition stabilized, and she was discharged successfully. Currently, there are no specific guidelines for the diagnosis and treatment of pseudoaneurysms in the abdominal cavity resulting from gastric cancer surgery. Early digital subtraction angiography examination should be performed to assist in formulating treatment plans. Early diagnosis and treatment contribute to an improved overall success rate of rescue interventions.
Sections du résumé
BACKGROUND
BACKGROUND
Postoperative delayed bleeding of gastric cancer is a complication of radical gastrectomy with low incidence rate and high mortality.
CASE PRESENTATION
METHODS
This case report presents the case of a 63-year-old female patient of Mongolian ethnicity who was diagnosed with gastric malignancy during a routine medical examination and underwent Billroth's I gastric resection in our department. However, on the 24th day after the surgery, she was readmitted due to sudden onset of hematemesis. Gastroscopy, abdominal CT, and digital subtraction angiography revealed postoperative anastomotic fistula, rupture of the duodenal artery, and bleeding from the abdominal aorta. The patient underwent three surgical interventions and two arterial embolizations. The patient's condition stabilized, and she was discharged successfully.
CONCLUSION
CONCLUSIONS
Currently, there are no specific guidelines for the diagnosis and treatment of pseudoaneurysms in the abdominal cavity resulting from gastric cancer surgery. Early digital subtraction angiography examination should be performed to assist in formulating treatment plans. Early diagnosis and treatment contribute to an improved overall success rate of rescue interventions.
Identifiants
pubmed: 38658989
doi: 10.1186/s13256-024-04531-1
pii: 10.1186/s13256-024-04531-1
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
218Subventions
Organisme : LiTao
ID : 2021BEG03087
Informations de copyright
© 2024. The Author(s).
Références
Marrelli D, Pedrazzani C, Neri A, et al. Complications after extended (D2) and superextended (D3) lymphadenectomy for gastric cancer: analysis of potential risk factors. Ann Surg Oncol. 2007;14(1):25–33. https://doi.org/10.1245/s10434-006-9063-3 .
doi: 10.1245/s10434-006-9063-3
pubmed: 17024558
Li QG, Li P, Tang D, Chen J, Wang DR. Impact of postoperative complications on long-term survival after radical resection for gastric cancer. World J Gastroenterol. 2013;19(25):4060–5. https://doi.org/10.3748/wjg.v19.i25.4060 .
doi: 10.3748/wjg.v19.i25.4060
pubmed: 23840153
pmcid: 3703195
Darnis B, Lebeau R, Chopin-Laly X, Adham M. Postpancreatectomy hemorrhage (PPH): predictors and management from a prospective database. Langenbecks Arch Surg. 2013;398(3):441–8. https://doi.org/10.1007/s00423-013-1047-8 .
doi: 10.1007/s00423-013-1047-8
pubmed: 23435636
Wente MN, Veit JA, Bassi C, et al. Postpancreatectomy hemorrhage (PPH): an International study group of pancreatic surgery (ISGPS) definition. Surgery. 2007;142(1):20–5. https://doi.org/10.1016/j.surg.2007.02.001 .
doi: 10.1016/j.surg.2007.02.001
pubmed: 17629996
Park JY, Kim YW, Eom BW, et al. Unique patterns and proper management of postgastrectomy bleeding in patients with gastric cancer. Surgery. 2014;155(6):1023–9. https://doi.org/10.1016/j.surg.2014.01.014 .
doi: 10.1016/j.surg.2014.01.014
pubmed: 24856122
Huang Q, Gao K, Zhai RY. Endovascular management of two episodes of late intraperitoneal hemorrhage following laparoscopic gastrectomy for gastric cancer. Mol Clin Oncol. 2014;2(4):549–52. https://doi.org/10.3892/mco.2014.288 .
doi: 10.3892/mco.2014.288
pubmed: 24940493
pmcid: 4051558
Li Z, Jie Z, Liu Y, Xie X. Management of delayed hemorrhage following radical gastrectomy for gastric carcinoma patients. Hepatogastroenterology. 2012;59(118):2016–9. https://doi.org/10.5754/hge11825 .
doi: 10.5754/hge11825
pubmed: 22282039
Kim DY, Joo JK, Ryu SY, Kim YJ, Kim SK, Jung YY. Pseudoaneurysm of gastroduodenal artery following radical gastrectomy for gastric carcinoma patients. World J Gastroenterol. 2003;9(12):2878–9. https://doi.org/10.3748/wjg.v9.i12.2878 .
doi: 10.3748/wjg.v9.i12.2878
pubmed: 14669359
pmcid: 4612078
Sugimoto H, Kaneko T, Ishiguchi T, et al. Delayed rupture of a pseudoaneurysm following pancreatoduodenectomy: report of a case. Surg Today. 2001;31(10):932–5. https://doi.org/10.1007/s005950170039 .
doi: 10.1007/s005950170039
pubmed: 11759894
Liu Y, Li D, Wen A. Pharmacologic prophylaxis of stress ulcer in non-ICU patients: a systematic review and network meta-analysis of randomized controlled trials. Clin Ther. 2020;42(3):488-498.e8. https://doi.org/10.1016/j.clinthera.2020.01.008 .
doi: 10.1016/j.clinthera.2020.01.008
pubmed: 32046894
Junfu W, YongLin XH, et al. Clinical analysis and prevention of delayed postoperative bleeding in D2 radical gastrectomy for gastric cancer. Chin J Clin Oncol. 2016;43(06):245–9.