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| Pancreatic cancer with gastrointestinal obstruction as an initial symptom |
| Jia-Ren Xu a , Xing-Nan Wu a , Yong-Qiang Si a , Jin-Pu Yang b , Xiao-Sun Liu a , ∗ |
a Department of Gastrointestinal Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
b Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
∗ Corresponding author.
E-mail address: xiaosunliu@zju.edu.cn (X.-S. Liu).
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Abstract Pancreatic cancer is the fourth leading cause of cancer mortality in the United States [1,2]. Risk factors of pancreatic cancer include smoking, family history of chronic pancreatitis, advanced age, male, diabetes mellitus, and obesity [1] . Most of patients have no obvious symptoms in the early stage, and are often diagnosed in the late stage and accompanied by invasion of surrounding tissues and distant metastasis, such as local lymph nodes, liver, lung and peritoneum [ 1 , 3 ]. Therefore, the prognosis is poor. The first manifestations of pancreatic cancer are mainly abdominal pain, weight loss, and upper abdominal mass [1] . Currently, the screening measures for pancreatic cancer usually include preoperative carbohydrate antigen 19-9 (CA19-9), ultrasound and computed tomography (CT). And the diagnosis depends on cytological diagnosis which is made with endoscopic ultrasound or CT-guided fine needle aspiration. These methods still have many shortcomings, such as low efficiency, poor specificity and small coverage. Pancreatic cancer with upper and lower digestive tract obstruction as the first manifestation is rare. We herein reported two patients, one of them was initially diagnosed with adenocarcinoma by duodenal biopsy and the other with adenocarcinoma by colon biopsy, and both were later diagnosed with pancreatic cancer. The treatments of pancreatic cancer include chemotherapy, radiation, and surgery, but they have a low success rate.
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2024, Vol. 23 
