Abdominal angina due to recurrence of cancer of the papilla of vater: a case report.

Gian Ludovico Rapaccini, Giovanni Battista Gasbarrini, Antonio Grieco, Marco Biolato, Maria Letizia Gabrieli, Antonio Parente, Melania Costantini, Lorenzo Bonomo, S. Racco

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

Abdominal angina is usually caused by atherosclerotic disease, and other causes are considered uncommon. This is the first report of a case of abdominal angina secondary to neoplastic vascular stenosis caused by local recurrence of an adenocarcinoma of the papilla of Vater. CASE PRESENTATION: An 80-year-old woman of Caucasian origin presented with abdominal pain and diarrhea. She had undergone a pancreaticoduodenectomy for adenocarcinoma of the papilla of Vater four years earlier. Computed tomography revealed a mass surrounding her celiac trunk and superior mesenteric artery. Her abdominal pain responded poorly to analgesic drugs, but disappeared when oral feedings were withheld. A duplex ultrasonography of the patient's splanchnic vessels was consistent with vascular stenosis. Parenteral nutrition was started and the patient remained pain free until her death. CONCLUSION: Pain relief is an important therapeutic target in patients with cancer. In this case, abdominal pain was successfully managed only after the ischemic cause had been identified. The conventional analgesic therapy algorithm based on nonsteroidal anti-inflammatory drugs and opioids had been costly and pointless, whereas the simple withdrawal of oral feeding spared the patient of the discomfort of additional invasive procedures and allowed her to spend her remaining days in a completely pain-free state.
Lingua originaleEnglish
pagine (da-a)N/A-N/A
RivistaJ Med Case Reports
Volume3
Stato di pubblicazionePubblicato - 2009

Keywords

  • abdominal angina

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