Toshimichi Onuma1, Yoshio Yoshida, Takara Yamamoto, Fumikazu Kotsuji. 1. From the Department of Obstetrics and Gynecology, Fukui Aiiku Hospital, Fukui-city, Japan; and the Department of Obstetrics and Gynecology, Fukui University Hospital, Eiheiji-tyou, Japan.
Abstract
BACKGROUND: Acute, persistent abdominal pain due to ruptured pancreatic carcinoma and perforated stomach is extremely rare during pregnancy. CASE: We evaluated a woman at 34 weeks of gestation presenting with uterine contractions. Computed tomography scanning revealed a large retroperitoneal mass, and her blood carbohydrate antigen 19-9 level was elevated. Immediately after an emergency cesarean delivery, pancreatic cancer was detected, and pancreatoduodenectomy was performed. The patient underwent chemotherapy and remains disease-free at 2 years. CONCLUSION: Delayed diagnosis and treatment are associated with high morbidity of both neonate and mother in cases of pancreatic cancer during pregnancy. Computed tomography scanning and carbohydrate antigen 19-9 levels are useful for diagnosis, after which radical surgery should be performed immediately in late pregnancy.
BACKGROUND: Acute, persistent abdominal pain due to ruptured pancreatic carcinoma and perforated stomach is extremely rare during pregnancy. CASE: We evaluated a woman at 34 weeks of gestation presenting with uterine contractions. Computed tomography scanning revealed a large retroperitoneal mass, and her blood carbohydrate antigen 19-9 level was elevated. Immediately after an emergency cesarean delivery, pancreatic cancer was detected, and pancreatoduodenectomy was performed. The patient underwent chemotherapy and remains disease-free at 2 years. CONCLUSION: Delayed diagnosis and treatment are associated with high morbidity of both neonate and mother in cases of pancreatic cancer during pregnancy. Computed tomography scanning and carbohydrate antigen 19-9 levels are useful for diagnosis, after which radical surgery should be performed immediately in late pregnancy.