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- Pancreatic malignancy
- portal vein thrombosis
- superior mesenteric vein occlusion
- variceal bleeding
- endovascular stenting
- hepatobiliary cancer
- pancreatic tumours
- gastrointestinal bleeding
A 50-year-old man with known metastatic pancreatic somatostatinoma was admitted with a 1-day history of haematemesis, melaena and haematochezia. Following an initial diagnosis 14 years earlier, he underwent distal pancreatectomy and splenectomy, followed by lateral hepatectomy a year later for residual hepatic disease, as well as biliary stenting for malignant obstructive jaundice. He was subsequently started on sunitinib, and his disease had remained stable before this presentation. At admission, he was haemodynamically stable, with haemoglobin concentration of 6.2 g/dl and platelet count of 126×109/l. Other blood tests were unremarkable. Oesophagogastroduodenoscopy revealed a large amount of blood in the stomach, portal hypertensive gastropathy and multiple gastric and duodenal varices, but no active bleeding from these or the biliary stent. …
Competing interests None.
Patient consent Obtained.
Ethics approval This was not a formal study but a report on the clinical management of a patient who presented with acute gastrointestinal bleeding. Formal ethics committee consent was not required, but patient consent was obtained.
Provenance and peer review Not commissioned; externally peer reviewed.