Pancreatic cancer masquerading as ischemic enteritis on endoscopy
Abstract Pancreatic tumors usually produce painless jaundice. Other associated symptoms may be secondary, from a direct extension of the tumor, resulting in bowel obstruction. It is extremely rare that pancreatic malignancy presents with ischemic enteritis by invasion of the major arteries, and no r...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-01-01
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| Series: | JGH Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jgh3.12421 |
| _version_ | 1830140222290001920 |
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| author | Enrik John T Aguila Carlos Paolo D Francisco Jonard T Co |
| author_facet | Enrik John T Aguila Carlos Paolo D Francisco Jonard T Co |
| author_sort | Enrik John T Aguila |
| collection | DOAJ |
| description | Abstract Pancreatic tumors usually produce painless jaundice. Other associated symptoms may be secondary, from a direct extension of the tumor, resulting in bowel obstruction. It is extremely rare that pancreatic malignancy presents with ischemic enteritis by invasion of the major arteries, and no report has documented it endoscopically. We present a rare case of pancreatic adenocarcinoma masquerading as ischemic enteritis diagnosed on enteroscopy and endoscopic ultrasound. An initial computed tomography (CT) scan performed in another hospital showed long segmental wall thickening involving the third part of the duodenum to the proximal segment of the jejunum. The patient was referred to our institution for enteroscopy, which showed a poorly distensible third part of the duodenum with purplish mucosa starting at the fourth part of the duodenum until the proximal jejunum. With suspicion of ischemic enteritis, a mesenteric CT angiography was performed, which showed a long segment circumferential wall thickening of the duodenum to jejunum with fullness of the pancreatic head and uncinate process that encases the superior mesenteric artery. Endoscopic ultrasound (EUS) showed a hypoechoic lesion at the head of the pancreas. EUS‐guided fine‐needle biopsy was performed, which revealed pancreatic adenocarcinoma on histopathology. |
| first_indexed | 2024-12-17T08:58:42Z |
| format | Article |
| id | doaj.art-e969985ec1ec487eb7b6b258d75a2f77 |
| institution | Directory Open Access Journal |
| issn | 2397-9070 |
| language | English |
| last_indexed | 2024-12-17T08:58:42Z |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | JGH Open |
| spelling | doaj.art-e969985ec1ec487eb7b6b258d75a2f772022-12-21T21:55:53ZengWileyJGH Open2397-90702021-01-015115715910.1002/jgh3.12421Pancreatic cancer masquerading as ischemic enteritis on endoscopyEnrik John T Aguila0Carlos Paolo D Francisco1Jonard T Co2Institute of Digestive and Liver Diseases St. Luke's Medical Center Global City Taguig PhilippinesInstitute of Digestive and Liver Diseases St. Luke's Medical Center Global City Taguig PhilippinesInstitute of Digestive and Liver Diseases St. Luke's Medical Center Global City Taguig PhilippinesAbstract Pancreatic tumors usually produce painless jaundice. Other associated symptoms may be secondary, from a direct extension of the tumor, resulting in bowel obstruction. It is extremely rare that pancreatic malignancy presents with ischemic enteritis by invasion of the major arteries, and no report has documented it endoscopically. We present a rare case of pancreatic adenocarcinoma masquerading as ischemic enteritis diagnosed on enteroscopy and endoscopic ultrasound. An initial computed tomography (CT) scan performed in another hospital showed long segmental wall thickening involving the third part of the duodenum to the proximal segment of the jejunum. The patient was referred to our institution for enteroscopy, which showed a poorly distensible third part of the duodenum with purplish mucosa starting at the fourth part of the duodenum until the proximal jejunum. With suspicion of ischemic enteritis, a mesenteric CT angiography was performed, which showed a long segment circumferential wall thickening of the duodenum to jejunum with fullness of the pancreatic head and uncinate process that encases the superior mesenteric artery. Endoscopic ultrasound (EUS) showed a hypoechoic lesion at the head of the pancreas. EUS‐guided fine‐needle biopsy was performed, which revealed pancreatic adenocarcinoma on histopathology.https://doi.org/10.1002/jgh3.12421endoscopyischemic enteritispancreaspancreatic cancer |
| spellingShingle | Enrik John T Aguila Carlos Paolo D Francisco Jonard T Co Pancreatic cancer masquerading as ischemic enteritis on endoscopy JGH Open endoscopy ischemic enteritis pancreas pancreatic cancer |
| title | Pancreatic cancer masquerading as ischemic enteritis on endoscopy |
| title_full | Pancreatic cancer masquerading as ischemic enteritis on endoscopy |
| title_fullStr | Pancreatic cancer masquerading as ischemic enteritis on endoscopy |
| title_full_unstemmed | Pancreatic cancer masquerading as ischemic enteritis on endoscopy |
| title_short | Pancreatic cancer masquerading as ischemic enteritis on endoscopy |
| title_sort | pancreatic cancer masquerading as ischemic enteritis on endoscopy |
| topic | endoscopy ischemic enteritis pancreas pancreatic cancer |
| url | https://doi.org/10.1002/jgh3.12421 |
| work_keys_str_mv | AT enrikjohntaguila pancreaticcancermasqueradingasischemicenteritisonendoscopy AT carlospaolodfrancisco pancreaticcancermasqueradingasischemicenteritisonendoscopy AT jonardtco pancreaticcancermasqueradingasischemicenteritisonendoscopy |