Pancreatic cancer curable
You are on page 1of 3 Search inside document Chirurgia Nr. Gen2, A. Dei pancreatic cancer curable progrese tehnice i de tratament, prognosticul rmne infaust. Dup diagnostic, n mod caracteristic, supravieuirea n medie este de luni de zile. Att infarctul ct i abcesul de splin, sunt complicaii destul de rare ale cancerului de pancreas.
2011-4-523
Diagnosticarea i tratamentul rapid sunt eseniale, deoarece s-a dovedit c situaia este cu risc vital crescut. Aici a fost prezentat un pacient pancreatic cancer curable infarct pancreatic cancer curable abces de splin care a aprut ca o complicaie a cancerului de coad de pancreas.
Tratamentul ales a fost pancreatectomie distal i splenectomie. Examenul clinic i imagistic, modificrile descoperite n diagnosticul diferenial a leziunilor de pancreas i de splin, impune luarea n discuie la un pacient cu stare septic a acestui gen de patologie.
Variabilitatea clinico-imagistic impune luarea n discuie a acestei patologii n diagnosticul diferenial al multor leziuni splenice i pancreatice.
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Cuvintele cheie: tumorile de pancreas, splin, abces, infarct Abstract Pancreatic tail adenocarcinoma is both a diagnostic and therapeutic challenge. Despite technical and therapeutic advances, the prognosis remains dismal; the average survival time after diagnosis is characteristically only five to eight months. Pancreatic cancer curable splenic infarction and abscess are very rare complications of pancreatic cancer.
In this case of splenic infarction, the possible source of emboli should be carefully investigated. In addition, splenic abscess must be suspected in patients with splenic infarction, especially if the infectious signs persist despite appropriate treatment.
Rapid diagnosis and treatment are essential as its course can prove fatal. Pancreatic cancer curable patient presented herein had a splenic infarct and abscess as complications of pancreatic tail carcinoma.
The treatment of choice was splenectomy and distal pancreatectomy with resection of involved organs. The variability in clinical presentation and imaging studies warrants consideration of this entity in the differential diagnosis of many splenic and pancreatic lesions.
Traducere "cancerul pancreatic" în engleză
Key words: pancreatic neoplasms, spleen, abscess, infarction Corresponding author: Gkhan ipe, MD. Clues related to splenic pancreatic cancer curable may be obscured, and the diagnosis is quite challenging even for experienced physicians or surgeons. However, splenic abscess caused by pancreatic cancer has been reported only rarely Splenic abscess must be suspected in patients with splenic infarction, especially if the infectious signs persist despite appropriate treatment.
Rapid cancer metastatic fever and treatment are essential, as its course can prove fatal. In clinical practice, diagnosis and management of splenic pancreatic cancer curable and abscess in association with pancreatic cancer are difficult because of the rarity of the condition.
Herein, we report the first case of splenic infarct and abscess in association with pancreatic cancer cured by definitive surgery.
Splenectomy, distal pancreatectomy and resection of the involved colonic segment were performed. Pathological examination revealed pancreatic ductal adenocarcinoma leading to invasion of the splenic hilus and colon together with splenic infarction and abscess. The postoperative period was uneventful, and the patient was discharged on the postoperative 7th day.
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Discussion Splenic infarction is a rare disorder that may present as acute abdomen 7. Occlusion of the splenic artery or its branches due to emboli or thrombi is the main cause.
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Splenic infarction commonly occurs in patients with atrial fibrillation, certain hematologic diseases and thromboembolism 8. Because of the anatomical relationship, namely, that the pancreas is a retroperitoneal organ in close proximity to the splenic vessels, splenic involvement can include infarction, abscess, intrasplenic pseudocysts, and hemorrhage 9 ; however, pancreatic cancer curable infarction caused by pancreatic cancer has been reported only rarely Pancreatic cancer curable the setting of splenic infarction associated with pancreatic cancer, infarction of the splenic artery may be caused principally by torsion, direct invasion of the tumor, compression, or thromboembolism.
In this case, splenic vessels were invaded by the tumor. It is also known that complex factors associated with cancer contribute to the hypercoagulable and thrombophilic state of cancer patients 10, Prompt diagnosis and appropriate antibiotic treatment are needed to reduce the risk of morbidity.
In addition, complications of splenic infarction, including splenic abscess, hemorrhage, or rupture should be carefully screened throughout the course of treatment.
Splenic abscess is uncommon, occurring in 0. Its diagnosis is difficult and its outcome is often fatal if left untreated. Although it may have various causes, it is most frequently associated with trauma and infections of the spleen. The latter are pancreatic cancer curable common in the presence of a different primary site of infection, especially endocarditis, or in cases of ischemic infarcts that are secondarily infected.
Moreover, immunosuppression is a major risk factor. However, splenic pancreatic cancer curable as a complication of pancreatic cancer has been reported in only a few cases to date Splenic pancreatic cancer curable is a rare entity that still presents a diagnostic challenge.
Since the clinical features may be misleading, the diagnosis is generally delayed even in the age of improved imaging technology In addition, the presence of underlying conditions may obscure the presentation, and vice versa. When splenic infarct or abscess is suspected, ultrasound may be the initial preferred modality, but in urgent cases, CT should be the first choice.
In the current case, a CT scan was the most useful imaging test.
The pathogenesis of splenic abscess is multifactorial, including pyogenic infection, splenic trauma, hemoglobinopathies, contiguous infection, and immunosuppression 6. We believe our case represents a contiguous infection. The colon wall and splenic capsule were simultaneously disrupted pancreatic cancer curable an extending pancreatic neoplasm, allowing bacterial seeding to Case presentation Ayear-old male consulted the emergency department of a local hospital due to sudden onset of left upper quadrant pain for two days.
The pain was severe and permanent. He reported fatigue, anorexia and weight loss of two months duration.
The initial investigation was inconclusive, and he was transferred to our tertiary hospital. The physical examination revealed tenderness over the left upper quadrant of the abdomen. His body temperature was Biochemical parameters were all normal.
Tumor markers were elevated CEA Because of pancreatic cancer curable excruciating pain, an urgent computed tomography CT was performed. CT study of the abdomen showed air-fluid level and nonenhancing hypodense areas in the spleen and irregular enlargement of the pancreatic tail, recumbent to the splenic hilus and colon Fig. The radiologic impression suggested splenic infarction and abscess with pancreatic cancer.
Considering these findings together, a final diagnosis of splenic infarction and abscess due to pancreatic cancer was made, and laparotomy and splenectomy were planned.
Operative findings revealed splenic infarct caused by pancreatic tail cancer invading the splenic hilus and splenic Figure 1.
Asta e exact aceeaşi problemă pentru chemoterapie şi cancerul pancreatic. And that's exactly the same problem for chemotherapy and pancreatic cancer. Operația Whipple e pentru cancerul pancreatic.
The appearence of the splenic abscess black arrow and splenic infarct white arrow on the CT scan the splenic parenchyma. Seeding of the spleen by a hematogenous spread of organisms that gained access to the vasculature after the colon wall was disrupted cannot be ruled out. For this reason, splenic infarction would have been predisposed to infection. However, in this patient, the nature of the splenic lesion in the pathologic examination suggests contiguous infection as the cause of the splenic abscess.
The location of the tumor appears to be an important factor in the development of splenic abscess. Pancreatic pancreatic cancer curable occurs most commonly pancreatic cancer curable the head, and as such, usually presents with obstructive jaundice. Conversely, the least common location for pancreatic carcinoma, as seen in our patient, is in the tail.
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These cancers tend to present later and are larger at presentation than pancreatic head tumors, with signs of advanced disease, such as contiguous organ extension, vascular invasion and distant metastases 5. In conclusion, this case is unique in the literature with the presentation of splenic infarct and abscess due to pancreatic tail cancer. Although seen rarely, we pancreatic cancer curable pay greater attention to potential splenic infarct and abscess in association with pancreatic cancer and should consider a multimodal management.
