Successful Management of Hemosuccus Pancreaticus due to Pancreatic Adenocarcinoma by Chemoradiotherapy

• Published in: Internal Medicine Vol. 59; no. 17; pp. 2135 - 2141
• Main Authors: Tomishima, Ko, Fujisawa, Toshio, Sato, Sho, Amano, Nozomi, Murata, Ayato, Tsuzura, Hironori, Sato, Shunsuke, Matsumoto, Kouhei, Shimada, Yuji, Wada, Ryo, Genda, Takuya, Isayama, Hiroyuki
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.09.2020; Japan Science and Technology Agency
• Subjects: Adenocarcinoma; Adenocarcinoma - complications; Adenocarcinoma - physiopathology; Adenocarcinoma - therapy; Adult; Aged; Aged, 80 and over; Anemia; bleeding; Blood transfusion; Case Report; Chemoradiotherapy; Chemoradiotherapy - methods; Chemotherapy; Female; Gastrointestinal Hemorrhage - etiology; Gastrointestinal Hemorrhage - therapy; hemosuccus pancreaticus; Humans; Internal medicine; Male; Middle Aged; Pancreas; pancreatic cancer; Pancreatic Ducts - physiopathology; Pancreatic Neoplasms - complications; Pancreatic Neoplasms - physiopathology; Treatment Outcome; chemoradiotherapy; pancreatic cancer; bleeding; hemosuccus pancreaticus
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.4372-19

Management of hemosuccus pancreaticus (HP) due to pancreatic adenocarcinoma is problematic. This is the first report of the successful management of HP caused by pancreatic adenocarcinoma by chemoradiotherapy, which is a treatment option for cases with a high surgical risk that are not suitable for interventional radiology. In the present case, bloody pancreatic juice was detected in the main pancreatic duct, and anemia worsened without repeated blood transfusions. The patient ultimately underwent chemoradiotherapy comprising radiation of 3 Gy in 15 fractions concomitant with systemic chemotherapy of S-1. After the treatments, the anemia improved, and the patient was discharged on day 45.