Year 2024 / Volume 116 / Number 1
Letter
Unusual complication of pancreatic adenocarcinoma: massive liver necrosis

51

DOI: 10.17235/reed.2023.9592/2023

María Desirée García García, José Manuel Gálvez Criado, Cristina Rodríguez Delgado, María Muñoz García-Borruel, Lourdes Grande Santamaría,

Abstract
Pancreatic adenocarcinoma is a malignant and aggressive disease, whose diagnose is achieved in many cases at advanced stage. We present the case of a 63-year-old woman diagnosed with adenocarcinoma of the pancreatic head and body, which invaded hepatic artery and presented with portal vein thrombosis. She consulted for melena and upper endoscopy showed varicose lesions in the second part of duodenum. The patient developed acute worsening of anemia with hemodynamic inestability. Urgent contrast enhanced computed tomography revealed a massive hepatic necrosis without identification of the hepatic artery. Massive hepatic necrosis is an infrequent clinical condition described in bibliography after invasive procedures. The complete obstruction of the liver vascular system due to pancreatic cancer is an extremely unusual cause of massive liver necrosis.
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References
1. Yamada K, Kawashima H, Ohno E, et al. Diagnosis of vascular invasion in pancreatic ductal adenocarcinoma using endoscopic ultrasound elastography. BMC Gastroenterol. 2020;20(1):81. Published 2020 Mar 30. doi:10.1186/s12876-020-01228-9
2. Yamamoto M, Zaima M, Yamamoto H, et al. Liver necrosis shortly after pancreaticoduodenectomy with resection of the replaced left hepatic artery. World J Surg Oncol. 2017;15(1):77. Published 2017 Apr 11. doi:10.1186/s12957-017-1151-2
3. Da Ines D, Buc E, Petitcolin V, et al. Massive hepatic necrosis with gastric, splenic, and pancreatic infarctions after ethanol ablation for hepatocellular carcinoma. J Vasc Interv Radiol. 2010;21(8):1301-1305. doi:10.1016/j.jvir.2010.04.011
4. Xue Z, Chen M, Zhang X, et al. Analysis of early hepatic artery thrombosis after liver transplantation. ANZ J Surg. 2018;88(3):172-176. doi:10.1111/ans.13911
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García García M, Gálvez Criado J, Rodríguez Delgado C, Muñoz García-Borruel M, Grande Santamaría L. Unusual complication of pancreatic adenocarcinoma: massive liver necrosis. 9592/2023


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Publication history

Received: 12/03/2023

Accepted: 13/03/2023

Online First: 19/04/2023

Published: 11/01/2024

Article Online First time: 38 days

Article editing time: 305 days


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