The online version of this article (doi:10.1186/1477-7819-10-199) contains supplementary material, which is available to authorized users.
The authors declare they have no competing interests. The authors have no conflict of interest to disclose which may have biased their work. The authors declare that they did not receive any funding for this work.
HZZ operated on the patient, collected the majority of relevant clinical data, and drafted the manuscript. KQH researched the literature for this case and contributed significantly with figures and relevant intellectual comments on the manuscript. JL operated on the patient, collected the majority of relevant clinical data, and helped significantly with the writing of the manuscript. PL had the idea to write this case report, participated significantly in its design and coordination, and helped to improve the intellectual content of the manuscript. GHZ provided relevant surgical experience and advice and helped to improve the intellectual content of the manuscript. YZ operated on the patient, collected the part of relevant clinical data. HYL carried out the histological examination of the resected specimen, including immunohistochemistry, and helped with the writing of the manuscript. All authors read and approved the final manuscript.
Gastrointestinal bleeding due to duodenal metastasis from renal cell carcinoma is extremely rare. Several previous reports have shown that embolic therapy or pancreatoduodenectomy (radical surgical resection) could be effective in controlling this type of clinical complication. Management is entirely dependent on the general condition and concurrent metastases at other sites. Optimizing the therapeutic strategies thus deserves further discussion and exploration.
In this report, we describe a patient with severe co-morbidities who underwent successful palliative wedge resection of duodenum and direct duodenal wall defect repair without reconstruction of duodeno-jejunostomy for acute upper digestive tract hemorrhage caused by duodenal metastasis from renal clear cell carcinoma.
The patient recovered uneventfully and did not experience rebleeding and frequent vomiting after surgery. Since then (1.5 years) he has had no evidence of rebleeding.
Gastrointestinal bleeding due to duodenal metastasis of RCC may benefit from emergent resection even in the presence of severe co-morbidities, and for palliative treatment.
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Sivaramakrishna B, Gupta NP, Wadhwa P, Hemal AK, Dogra PN, Seth A, Aron M, Kumar R: Pattern of metastases in renal cell carcinoma: a single institution study. Indian J Cancer. 2005, 42: 173-177. PubMed
Nabi G, Gandhi G, Dogra PN: Diagnosis and management of duodenal obstruction due to renal cell carcinoma. Trop Gastroenterol. 2001, 22: 47-49. PubMed
- A case of wedge resection of duodenum for massive gastrointestinal bleeding due to duodenal metastasis by renal cell carcinoma
- BioMed Central
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