{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T15:02:40Z","timestamp":1773414160010,"version":"3.50.1"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2022,10,23]],"date-time":"2022-10-23T00:00:00Z","timestamp":1666483200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Pancreatic cancer often invades the duodenum; however, it rarely causes duodenal bleeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Presentation of case:<\/jats:title>\n                    <jats:p>We describe a case of a 77-year-old Japanese woman admitted to our hospital with hematemesis, who presented with pancreatic head cancer and received radiochemotherapy (radiotherapy + gemcitabine). The following day, she developed hemorrhagic shock, and an emergency endoscopy was performed, which revealed a bleeding ulcerative lesion in the second portion of the duodenum. We chose surgical treatment over other therapies (interventional radiology or endoscopy). Pancreaticoduodenectomy was successfully performed to control hemorrhage and the Child's method was used for reconstruction. The patient's postoperative course was uneventful. After her condition improved, she was treated for residual cancer 2 months after surgical treatment; therefore, complementary radiation with concurrent chemotherapy based on GEM was administrated. However, she died 12 months after the surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and conclusion:<\/jats:title>\n                    <jats:p>During the treatment of pancreatic cancer, it is necessary to avoid bleeding as much as possible by considering prophylactic treatment, including periodic gastrointestinal scrutiny and resection or embolization, depending on the case.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2022.107768","type":"journal-article","created":{"date-parts":[[2022,10,26]],"date-time":"2022-10-26T12:55:17Z","timestamp":1666788917000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Hemorrhagic shock successfully treated with emergency pancreaticoduodenectomy for pancreatic carcinoma in radiochemotherapy"],"prefix":"10.1097","volume":"101","author":[{"given":"Yoshito","family":"Wada","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Taniwaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hironori","family":"Yoshimoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koji","family":"Hayashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yosuke","family":"Morimits","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-3-20260313","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1007\/BF02924198","article-title":"Massive gastrointestinal bleeding as the initial manifestation of pancreatic carcinoma","volume":"15","author":"Lee","year":"1994","journal-title":"Int. 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Gastroenterol"},{"key":"R7-3-20260313","first-page":"706","article-title":"A case of anaplastic carcinoma of the pancreas, disclosed a hemosuccus pancreaticus","volume":"94","author":"Mizukami","year":"1997","journal-title":"J. Jpn. Panc. Soc"},{"key":"R8-3-20260313","first-page":"2666","article-title":"A resected case of pancreatic metastasis from renal cell carcinoma presenting with acute duodenal bleeding","volume":"54","author":"Aiko","year":"1993","journal-title":"J. Jpn. Surg. Assoc"},{"key":"R9-3-20260313","first-page":"2269","article-title":"Is pancreatic resection justified for metastasis of papillary thyroid cancer?","volume":"26","author":"Meyer","year":"2006","journal-title":"Anticancer Res"},{"key":"R10-3-20260313","doi-asserted-by":"crossref","first-page":"583","DOI":"10.5833\/jjgs.39.583","article-title":"A case of adenocarcinoma arising in heterotopic pancreas with gastrointestinal bleeding","volume":"39","author":"Kaneko","year":"2006","journal-title":"Jpn. J. Gastroenterol. Surg"},{"key":"R11-3-20260313","doi-asserted-by":"crossref","first-page":"282","DOI":"10.5833\/jjgs.2012.0136","article-title":"A resected case of pancreatic head cancer induced duodenal penetration and bleeding during neoadjuvant chemoradiation","volume":"46","author":"Okumura","year":"2013","journal-title":"Jpn J Gastroenterol Surg"},{"key":"R12-3-20260313","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1159\/000364819","article-title":"Duodenal hemorrhage from pancreatic cancer therapy infiltration controlled through combination therapy with gemcitabine and S-1","volume":"8","author":"Takada","year":"2014","journal-title":"Case Rep Gastroenterol"},{"key":"R14-3-20260313","doi-asserted-by":"crossref","first-page":"172","DOI":"10.2958\/suizo.23.172","article-title":"Hematemesis as the initial manifestation of pancreatic cancer directly invading the duodenum: a case report","volume":"23","author":"Hirai","year":"2008","journal-title":"J Jpn Panc Soc"},{"key":"R15-3-20260313","first-page":"459","article-title":"A case of endoscopic hemostasis with intra-aortic balloon occlusion for severe bleeding from duodenal invasion pancreatic carcinoma","volume":"55","author":"Yamada","year":"2013","journal-title":"Gastroenterol. Endosc"},{"key":"R16-3-20260313","first-page":"767","article-title":"Hematoemesis as the initial complication of pancreatic adenocarcinoma directly invading the duodenum: a case report","volume":"11","author":"Lin","year":"2005","journal-title":"J. Gastroenterol"},{"key":"R17-3-20260313","doi-asserted-by":"crossref","first-page":"26","DOI":"10.11641\/pde.66.2_26","article-title":"Study of 11 cases which were performed endoscopic hemostasis for bleeding from the second portion of the duodenum","volume":"66","author":"Sakamoto","year":"2005","journal-title":"Prog Dig Endosc"},{"key":"R18-3-20260313","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1177\/000313480607200419","article-title":"Pancreatic cancer presenting with hematemesis from directly invading the duodenum: report of an usual manifestation and review","volume":"72","author":"Tomita","year":"2006","journal-title":"Am. 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A dual non-trauma centre experience and literature review","volume":"21","author":"Lissidini","year":"2015","journal-title":"Int. J. 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