دورية أكاديمية
Intratumoral Air Bubbles and Hematemesis As Predictors of Pseudoaneurysm Rupture in Unresected Pancreatic Cancer.
| العنوان: | Intratumoral Air Bubbles and Hematemesis As Predictors of Pseudoaneurysm Rupture in Unresected Pancreatic Cancer. |
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| المؤلفون: | Terada S; Department of Gastroenterology, Shizuoka General Hospital, Japan., Satoh T; Department of Gastroenterology, Shizuoka General Hospital, Japan., Endo S; Department of Gastroenterology, Shizuoka General Hospital, Japan., Hawke P; School of Pharmaceutical Sciences, University of Shizuoka, Japan., Nakatani E; Graduate School of Public Health (Medical Statistics), Shizuoka Graduate University of Public Health, Japan., Sato Y; Graduate School of Public Health (Medical Statistics), Shizuoka Graduate University of Public Health, Japan., Yamamoto T; Department of Radiology, Shizuoka General Hospital, Japan., Kawaguchi S; Department of Gastroenterology, Shizuoka General Hospital, Japan. |
| المصدر: | Internal medicine (Tokyo, Japan) [Intern Med] 2023 Jul 01; Vol. 62 (13), pp. 1879-1886. Date of Electronic Publication: 2022 Nov 16. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Japanese Society of Internal Medicine Country of Publication: Japan NLM ID: 9204241 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1349-7235 (Electronic) Linking ISSN: 09182918 NLM ISO Abbreviation: Intern Med Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Tokyo, Japan : Japanese Society of Internal Medicine, [1992- |
| مواضيع طبية MeSH: | Hemobilia*/etiology , Aneurysm, False*/complications , Aneurysm, False*/diagnostic imaging , Pancreatic Neoplasms*/complications, Humans ; Hematemesis/etiology ; Case-Control Studies ; Retrospective Studies ; Gastrointestinal Hemorrhage/diagnostic imaging ; Gastrointestinal Hemorrhage/epidemiology ; Gastrointestinal Hemorrhage/etiology |
| مستخلص: | Objective Pseudoaneurysm rupture associated with unresected pancreatic cancer can cause rare but fatal hemobilia and gastrointestinal bleeding. This study aimed to identify factors predicting pseudoaneurysm rupture. Methods We conducted a single-center case-control study of unresected pancreatic cancer patients treated at Shizuoka General Hospital between January 2011 and July 2020 using a retrospective cancer registry database. Included in the study were 611 consecutive patients with unresected pancreatic cancer, of whom 55 developed overt upper gastrointestinal bleeding or hemobilia. Twenty patients were excluded, as they had not undergone contrast-enhanced computed tomography (CT) or angiography. Patients were classified into pseudoaneurysm and non-pseudoaneurysm groups. One patient with arterial bleeding but without obvious pseudoaneurysm was included in the pseudoaneurysm group. Factors predicting pseudoaneurysm rupture at the onset of overt gastrointestinal bleeding were investigated using a logistic regression analysis. CT findings revealing air bubbles inside the tumor were described as intratumoral air bubbles. Results Thirty-five patients were included (15 in the pseudoaneurysm group, 20 in the non-pseudoaneurysm group). In the multivariate analysis, intratumoral air bubbles [odds ratio (OR), 12.9; 95% confidence interval (CI), 2.14-77.9; p=0.005] and hematemesis (OR, 6.30; 95% CI, 1.03-38.6; p=0.047) were independent predictors of pseudoaneurysm rupture. In addition, patients who experienced successful hemostasis and were re-administered chemotherapy survived more than six months. Conclusion This study reveals that intratumoral air bubbles and hematemesis may predict pseudoaneurysm rupture at the onset of overt gastrointestinal bleeding. For patients presenting these findings, an examination with conventional or CT angiography may lead to an early diagnosis and improve the patient prognosis. |
| References: | Cardiovasc Intervent Radiol. 2010 Dec;33(6):1128-34. (PMID: 20857110) Endoscopy. 2010;42 Suppl 2:E27-8. (PMID: 20073006) Epidemiology. 1991 Sep;2(5):359-62. (PMID: 1742385) Ann Med Surg (Lond). 2021 Feb 02;63:102143. (PMID: 33643648) Endoscopy. 2014 Mar;46(3):248-51. (PMID: 24573734) Bone Marrow Transplant. 2013 Mar;48(3):452-8. (PMID: 23208313) Surg Endosc. 2014 Jul;28(7):2027-38. (PMID: 24519028) Br J Radiol. 2020 Apr;93(1108):20190637. (PMID: 31778313) Eur J Radiol Open. 2020 Feb 12;7:100221. (PMID: 32099872) J Vasc Interv Radiol. 2013 Nov;24(11):1623-31. (PMID: 24035417) Nihon Shokakibyo Gakkai Zasshi. 2019;116(9):754-763. (PMID: 31511462) VideoGIE. 2020 Sep 30;6(1):24-26. (PMID: 33490750) J Vasc Surg. 2011 Apr;53(4):966-70. (PMID: 21216559) |
| فهرسة مساهمة: | Keywords: diagnosis; gastrointestinal bleeding; hemobilia; pancreatic cancer; pseudoaneurysm |
| تواريخ الأحداث: | Date Created: 20221117 Date Completed: 20230704 Latest Revision: 20230729 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC10372266 |
| DOI: | 10.2169/internalmedicine.0856-22 |
| PMID: | 36384903 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1349-7235 |
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| DOI: | 10.2169/internalmedicine.0856-22 |