Baybora KIRCALI, Tülay SARIÇAM, Ayşegül ÖZAKYOL, Eser VARDARELİ

Üst gastrointestinal sistem kanamasının nadir sebebi: Villöz adenom zemininde gelişmiş duodenal adenokarsinom

Primer duodenal adenokarsinomlar tüm gastrointestinal malinitelerin %0.5'lik kısmını oluşturur. Bu tümörler gizli kan kaybı ve kendi kendini sınırlayan kanamayla karakterlidir. Biz tekrarlayan, klinik olarak anlamlı gastrointestinal kanamaya neden olan duodenal adenokarsinom olgusunu rapor ettik. Olgu: 59 yaşındaki erkek hasta 1 aydır tekrarlayan melena yakınmasıyla yatırıldı. Öyküde 1,5 ayda 8 kg kayıp ve fizik incelemede anemi bulguları mevcuttu. Laboratuvar incelemede Hb: 7.5 gr/dl, MCV: 69 sedimentasyon: 6 mm/h olarak saptandı. Endoskopide, bulbusun ön duvarı ve duodenum 2. kısmını içine alan aktif kanamalı ülserovejetan kitle lezyonu gözlendi. Kanamanın devam etmesi nedeniyle cerrahiye devredilen hastaya Whipple operasyonu uygulandı. Patolojik inceleme sonucu evre III villöz adenomdan kaynaklanan primer duodenal adenokarsinom tespit edildi.

Anahtar Kelimeler:

Üst gastrointestinal kanama, primer duodenal adenokarsinom, villöz adenom

Rare cause of upper gastrointestinal bleeding: Primer adenocarcinoma of the duodenum arising from villous adenoma

Duodenal adenocarcinomas account for 0.5% of all gastrointestinal malignancies. These malignancies are generally characterized by blood loss and self-limited bleeding. We report adenocarcinoma of the duodenum causing recurrent, clinically significant bleeding. Case: A 59-year-old male was admitted to hospital with recurrent melena. History revealed an 8 kg weight loss in 1.5 months, and signs of anemia were observed on physical examination. Hb: 7.5 g/dl, MCV: 69.7, and sedimentation rate of 6 mm/h were detected in laboratory examination. An actively bleeding, ulcero-vegetan mass involving the anterior wall of the bulbus and second part of the duodenum was observed in endoscopy. Since active bleeding continued, Whipple operation was applied in the Surgery Department. Pathologic examination of the surgical samples showed stage III, primary adenocarcinoma of the duodenum arising from villous adenoma

Keywords:

Upper gastrointestinal bleeding, duodenal adenocarcinoma, villous adenoma,

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