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Case Report
A Rare Case of Early Gastric Cancer Combined with Underlying Heterotopic Pancreas
Jung Bin Yoon, Bong Eun Lee, Dae Hwan Kim, Do Youn Park, Hye Kyung Jeon, Dong Hoon Baek, Gwang Ha Kim, Geun Am Song
Clin Endosc 2018;51(2):192-195.   Published online August 31, 2017
DOI: https://doi.org/10.5946/ce.2017.055
AbstractAbstract PDFPubReaderePub
Heterotopic pancreas in the stomach is usually asymptomatic and benign. Here, we presented a rare case of an early gastric cancer overlying a heterotopic pancreas. A 48-year-old woman underwent esophagogastroduodenoscopy, which revealed a subepithelial mass measuring 2.0×1.5 cm on the gastric antrum with a 1-cm erosive erythematous discoloration on the surface. A biopsy specimen showed moderately differentiated tubular adenocarcinoma. Endosonography showed a heterogeneous hypoechoic mass measuring 1.3×0.6 cm, with indistinct margins in the second and third layers of the gastric wall; anechoic tubular structures within the mass were suggestive of heterotopic pancreas. Distal gastrectomy was performed, which confirmed an early gastric cancer confined to the mucosa, and a separate underlying heterotopic pancreas. Although heterotopic pancreas is most likely benign, careful endoscopic observation of the mucosal surface is necessary to avoid overlooking a coincident early gastric cancer.

Citations

Citations to this article as recorded by  
  • Duodenal Heterotopic Pancreas with a Large Retention Cyst: A Case Report and Literature Review
    Shinya Kawaguchi, Akinori Murakami, Masato Nishida
    Internal Medicine.2023; 62(5): 723.     CrossRef
  • Gastric ectopic pancreas combined with synchronous multiple early gastric cancer: A rare case report
    Zhen-Ya Zhao, Yue-Xing Lai, Ping Xu
    World Journal of Clinical Cases.2023; 11(7): 1569.     CrossRef
  • A rare case of enlarged gastric heterotopic pancreas with retention cysts: A case report and literature review
    Keiso Matsubara, Michihiro Ishida, Toshiaki Morito, Tetsushi Kubota, Yasuhiro Choda, Masao Harano, Hiroyoshi Matsukawa, Hitoshi Idani, Shigehiro Shiozaki, Masazumi Okajima
    International Journal of Surgery Case Reports.2020; 74: 284.     CrossRef
  • A case of gastric heterotopic pancreas with gastroduodenal invagination
    Shoko Iwahashi, Masaaki Nishi, Toshiaki Yoshimoto, Hideya Kashihara, Chie Takasu, Takuya Tokunaga, Tomohiko Miyatani, Jun Higashijima, Kozo Yoshikawa, Yuma Wada, Yoshimi Bando, Mitsuo Shimada
    Surgical Case Reports.2019;[Epub]     CrossRef
  • 6,903 View
  • 182 Download
  • 4 Web of Science
  • 4 Crossref
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Commentary
Second-Look Endoscopy after Endoscopic Submucosal Dissection: Can We Obtain Valuable Information?
Hye Kyung Jeon, Gwang Ha Kim
Clin Endosc 2016;49(3):212-213.   Published online May 9, 2016
DOI: https://doi.org/10.5946/ce.2016.062
PDFPubReaderePub

Citations

Citations to this article as recorded by  
  • Bleeding Risk Factors after Endoscopic Submucosal Dissection in Early Gastric Cancer and the Necessity of “Second-Look” Endoscopic Examination on the following Day
    Rika Kobayashi, Ken Kawaura, Tohru Ito, Sadafumi Azukisawa, Hiroaki Kunou, Junji Kamai, Kazu Hamada, Tsuyoshi Mukai, Hidekazu Kitakata, Yasuhito Ishigaki
    Journal of Clinical Medicine.2022; 11(4): 914.     CrossRef
  • 7,511 View
  • 67 Download
  • 1 Web of Science
  • 1 Crossref
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Focused Review Series: Endoscopic Management of Upper Gastrointestinal Bleeding
Endoscopic Management of Dieulafoy's Lesion
Hye Kyung Jeon, Gwang Ha Kim
Clin Endosc 2015;48(2):112-120.   Published online March 27, 2015
DOI: https://doi.org/10.5946/ce.2015.48.2.112
AbstractAbstract PDFPubReaderePub

A Dieulafoy's lesion is a vascular abnormality consisting of a large caliber-persistent tortuous submucosal artery. A small mucosal defect with the eruption of this protruding vessel can cause bleeding. In fact, a Dieulafoy's lesion is a relatively rare but potentially life-threatening condition. It accounts for 1% to 2% of cases of acute gastrointestinal bleeding. Although there is no consensus on the treatment of Dieulafoy's lesions; treatment options depend on the mode of presentation, site of the lesion, and available expertise. Endoscopic therapy is usually successful in achieving primary hemostasis, with hemostasis success rates reaching 75% to 100%. Although various therapeutic endoscopic methods are used to control bleeding in Dieulafoy's lesions, the best method for endoscopic intervention is not clear. Combination endoscopic therapy is known to be superior to monotherapy because of a lower rate of recurrent bleeding. In addition, mechanical therapies including hemostatic clipping and endoscopic band ligation are more effective and successful in controlling bleeding than other endoscopic methods. Advances in endoscopic techniques have reduced mortality in patients with Dieulafoy's lesion-from 80% to 8%-and consequently, the need for surgical intervention has been reduced. Currently, surgical intervention is used for cases that fail therapeutic endoscopic or angiographic interventions.

Citations

Citations to this article as recorded by  
  • Dieulafoy's lesion: Is there still a place for surgery? About 2 cases
    Souhaib Atri, Mahdi Hammami, Yacine Ouadi, Amine Sebai, Youssef Chaker, Montassar Kacem
    International Journal of Surgery Case Reports.2024; 114: 109166.     CrossRef
  • Over-the-scope clip as a rescue treatment for massive bleeding due to Dieulafoy lesion at the colorectal anastomosis: A case report
    Ping Han, Demin Li, Qiaozhen Guo, Yu Lei, Jingmei Liu, Dean Tian, Wei Yan
    Medicine.2024; 103(16): e37871.     CrossRef
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    BMJ Open Gastroenterology.2024; 11(1): e001299.     CrossRef
  • Usage of Padlock Over-the-Scope-Clip in Difficult-to-Control Recurrent Gastrointestinal Bleeding Due to a Gastric Dieulafoy Lesion
    John Joyce, Vishnu Kumar, Dayana Nasr, Ganesh Aswath, Hafiz M. Khan, Savio John
    Journal of Investigative Medicine High Impact Case Reports.2024;[Epub]     CrossRef
  • Can Segmental Branch Embolization of the Left Gastric Artery Be an Alternative in the Treatment of Recurrent Dieulafoy Lesion Bleeding? A Case report
    Gamze Sönmez, Serez İleri, Ferdi Çay, Bora Peynircioğlu, Onur Keskin
    Akademik Gastroenteroloji Dergisi.2024; 23(2): 67.     CrossRef
  • Severe low gastrointestinal bleeding due to Dieulafoy's lesion: A report of two cases and review of literature
    Cheng‐Chi Lee, Jen‐Chieh Huang, Jeng‐Shiann Shin
    Advances in Digestive Medicine.2023; 10(4): 254.     CrossRef
  • A bleeding duodenal lesion
    Jhih‐Jie Lin, Ming‐Jen Chen
    Advances in Digestive Medicine.2023; 10(3): 195.     CrossRef
  • Dieulafoy’s Disease in Stomach and Duodenum-Recurrent Upper Gastrointestinal Bleeding
    Guang-sheng Gao, Feng-qin Ren, Xin-xin Zhang, Xing-sheng Wang, Yun Li
    Indian Journal of Surgery.2023; 85(6): 1464.     CrossRef
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    Benjamin Lew, Dennis E. Der, Brian S. Lim
    ACG Case Reports Journal.2023; 10(4): e01032.     CrossRef
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    C.A. Martínez-Ortiz, E.D. Alvarez-Sores, U. Lara-Orozco, E. Murcio-Pérez
    Revista de Gastroenterología de México.2023; 88(3): 301.     CrossRef
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    C.A. Martínez-Ortiz, E.D. Alvarez-Sores, U. Lara-Orozco, E. Murcio-Pérez
    Revista de Gastroenterología de México (English Edition).2023; 88(3): 301.     CrossRef
  • Retrospective analysis of patients with Dieulafoy’s lesions
    Bünyamin SARITAŞ, Şehmus ÖLMEZ, Adnan TAŞ, Nevin AKÇAER ÖZTÜRK, Banu KARA
    Akademik Gastroenteroloji Dergisi.2023; 22(3): 136.     CrossRef
  • Gastrointestinal Bleeding From a Transverse Colon Dieulafoy Lesion
    Xinyu Xie, Jian Qin, Xiaojua Ma, Shanshan Liu
    Cureus.2023;[Epub]     CrossRef
  • Dieulafoy's lesion: a rare but potentially life-threatening cause of gastrointestinal bleeding
    Eleanor Apthorp, Marta Mungai Ndungu, Kelum Rumwanpura, Muhammad JH Rahmani
    British Journal of Hospital Medicine.2023; 84(11): 1.     CrossRef
  • Intragastric Single-Port Surgery: An Innovative and Multipurpose Technique for the Therapy of Upper Digestive Tract Lesions
    Renjie Li, Wilfried Veltzke-Schlieker, Andreas Adler, Mahmoud Ismail, Harun Badakhshi, Ricardo Zorron
    Surgical Innovation.2022; 29(1): 56.     CrossRef
  • Rectal Dieulafoy Lesion
    Erika Koga, Satoshi Ashimine, Atsushi Iraha, Akira Hokama
    Chonnam Medical Journal.2022; 58(1): 48.     CrossRef
  • Therapeutic endoscopy of a Dieulafoy lesion in a 10-year-old girl: A case report
    Ying Chen, Mei Sun, Xu Teng
    World Journal of Clinical Cases.2022; 10(6): 1966.     CrossRef
  • Diagnosis and Treatment of a Recurrent Bleeding Dieulafoy’s Lesion: A Case Report
    Amanda R Levy, Sierra Broad, James R Loomis III, Julie A Thomas
    Cureus.2022;[Epub]     CrossRef
  • Severe lower gastrointestinal bleeding caused by rectal Dieulafoy’s lesion: Case reports and literature review
    Ping Han, Yu Lei, Wei Hou, Nianjun Chen, Jingmei Liu, Dean Tian, Qiaozhen Guo, Wei Yan
    Medicine.2022; 101(48): e32031.     CrossRef
  • Jejunal Dieulafoy’s Lesion: A Systematic Review of Evaluation, Diagnosis, and Management
    Adnan Malik, Faisal Inayat, Muhammad Hassan Naeem Goraya, Talal Almas, Rizwan Ishtiaq, Sohira Malik, Zahid Ijaz Tarar
    Journal of Investigative Medicine High Impact Case Reports.2021; 9: 232470962098770.     CrossRef
  • Role of imaging and endovascular radiology in endoscopically missed Dieulafoy’s lesion of stomach – A case report with review
    Divyesh Dadhania, Jineesh Valakkada, Anoop Ayyappan, Santhosh Kannath
    BJR|case reports.2021;[Epub]     CrossRef
  • Incidental massive lower gastrointestinal hemorrhage caused by a rectal Dieulafoy’s lesion
    Genesis Perez Del Nogal, Rangesh Modi, Ivania Salinas, Kalyan Chakrala
    BMJ Case Reports.2021; 14(9): e244264.     CrossRef
  • Massively bleeding Dieulafoy lesion and unique rescue: a video based case report from National Liver Institute, Menoufia University
    Omkolsoum Alhaddad, Maha Elsabaawy, Ahmed Elfaioumy, Ashraf Eljaky
    Egyptian Liver Journal.2021;[Epub]     CrossRef
  • Modern management of acute non-variceal upper gastrointestinal bleeding
    V. V. Darvin, A. Ya. Ilkanich, M. G. Ryzhikov, A. V. Oganian, A. V. Satinov
    Сибирский научный медицинский журнал.2021; 41(6): 4.     CrossRef
  • Trans‐ileostomy management to Dieulafoy's lesion
    Bhavik Patel, Natasha R. Jeenah, Russell Canavan, Martin Wullschleger
    ANZ Journal of Surgery.2020; 90(6): 1168.     CrossRef
  • Hemorragia digestiva alta no varicosa
    P. Cañamares Orbis, C. Borao Laguna, l. Sánchez Miguel, G. Hijos Mallada, A. Lanas Arbeloa
    Medicine - Programa de Formación Médica Continuada Acreditado.2020; 13(3): 136.     CrossRef
  • A case of the lower gastrointestinal bleeding due to Dieulafoy’s ulcer in the cecum
    Keisuke Kinoshita, Osamu Matsunari, Akira Sonoda, Kensuke Fukuda, Kazuhisa Okamoto, Ryo Ogawa, Kazuhiro Mizukami, Tadayoshi Okimoto, Masaaki Kodama, Kazunari Murakami
    Clinical Journal of Gastroenterology.2020; 13(4): 564.     CrossRef
  • Tratamiento quirúrgico de la hemorragia digestiva alta por enfermedad de Dieulafoy
    José Ángel Zamora-Soler, Vanesa Maturana-Ibáñez
    Revista Colombiana de Cirugía .2020; 35(1): 113.     CrossRef
  • Dieulafoy lesion: two pediatric case reports
    Giovanni Di Nardo, Gianluca Esposito, Angela Mauro, Letizia Zenzeri, Gian Paolo Ciccarelli, Andrea Catzola, Alessandro Rossi, Vito Domenico Corleto
    Italian Journal of Pediatrics.2020;[Epub]     CrossRef
  • Massive Gastrointestinal Bleeding From a Jejunal Dieulafoy's Lesion
    Palashkumar Jaiswal, Mairin Joseph-Talreja, John Anthony Teotico, Evan Grossman
    ACG Case Reports Journal.2020; 7(6): e00400.     CrossRef
  • Endoscopic full-thickness resection to treat active Dieulafoy's disease: A case report
    Shan Yu, Xiao-Ming Wang, Xin Chen, Hong-Yan Xu, Guang-Jie Wang, Na Ni, Yu-Xin Sun
    World Journal of Gastroenterology.2020; 26(30): 4557.     CrossRef
  • Lesión de Dieulafoy rectal: una causa rara, pero potencialmente mortal de hemorragia del tubo digestivo bajo
    Benjamín Gallo Arriaga,  José Raúl  Nieto Saucedo, Benjamín Gallo Chico,  J Jesús  Ibarra Rodríguez, Karla Edith  Santibáñez Bedolla, Carlos  Hidalgo Valadez
    Acta Médica Grupo Ángeles.2020; 18(3): 302.     CrossRef
  • Dieulafoy disease with gastric MALT lymphoma
    Qin Zeng, Jin Feng Dai, Haijun Cao, Shuo Zhang
    Medicine.2020; 99(41): e22651.     CrossRef
  • Dieulafoy’s lesion: an unexpected and rare cause of upper gastrointestinal bleeding
    Saravana Kumar Rajanthran, Harjit Chaal Singh, Da Jun Than, Firdaus Hayati
    BMJ Case Reports.2020; 13(12): e240905.     CrossRef
  • Endoscopic management of nonvariceal upper gastrointestinal bleeding
    Pablo Cañamares-Orbís, Francis K.L. Chan
    Best Practice & Research Clinical Gastroenterology.2019; 42-43: 101608.     CrossRef
  • Finding the Dieulafoy’s Lesion: A Case of Recurrent Rectal Bleeding in an Immunosuppressed Patient
    Caleb Hudspath, Dylan Russell, Ki Eum, Joel Guess, Jessica Bunin, Franklin Goldwire
    Case Reports in Gastrointestinal Medicine.2019; 2019: 1.     CrossRef
  • Hemorragia digestiva recurrente por lesión de Dieulafoy tratada con éxito mediante esclerosis guiada por ecoendoscopia
    Irene García de la Filia, Nerea Hernanz, Enrique Vázquez Sequeiros, Eduardo Tavío Hernández
    Gastroenterología y Hepatología.2018; 41(5): 319.     CrossRef
  • Endoscopic Management of Nonvariceal, Nonulcer Upper Gastrointestinal Bleeding
    Michael A. Chang, Thomas J. Savides
    Gastrointestinal Endoscopy Clinics of North America.2018; 28(3): 291.     CrossRef
  • A Retrospective Analysis of Cyanoacrylate Injection versus Hemoclip Placement for Bleeding Dieulafoy’s Lesion in Duodenum
    Yu Jiang, Julong Hu, Ping Li, Wen Jiang, Wenyan Liang, Hongshan Wei
    Gastroenterology Research and Practice.2018; 2018: 1.     CrossRef
  • Recurrent gastrointestinal bleeding secondary to Dieulafoy's lesion successfully treated with endoscopic ultrasound-guided sclerosis
    Irene García de la Filia, Nerea Hernanz, Enrique Vázquez Sequeiros, Eduardo Tavío Hernández
    Gastroenterología y Hepatología (English Edition).2018; 41(5): 319.     CrossRef
  • Case 1: Hematemesis in a 30-month-old Boy
    Sudarshawn Damodharan, Istvan Danko
    Pediatrics In Review.2018; 39(11): 560.     CrossRef
  • Dieulafoy’s lesion of the duodenum: a comparative review of 37 cases
    Faisal Inayat, Waseem Amjad, Qulsoom Hussain, Abu Hurairah
    BMJ Case Reports.2018; : bcr-2017-223246.     CrossRef
  • Postural Syncope and Constipation: An Unusual Presentation of a Duodenal Dieulafoy’s Lesion
    Ahmed Dirweesh, Alvarez Chikezie, Muhammad Yasir Khan, Sana Zia, Muhammad Tahir
    Case Reports in Gastrointestinal Medicine.2017; 2017: 1.     CrossRef
  • Dieulafoy of cecum: A rare cause of a refractory gastrointestinal bleeding in an uncommon location
    Hamzeh Saraireh, Muhannad Al Hanayneh, Habeeb Salameh, Sreeram Parupudi
    Digestive and Liver Disease.2017; 49(9): 1062.     CrossRef
  • Gastric cirsoid aneurysm: Uncommon cause of death from upper GI bleed
    Tatiana Bihun, James Ribe
    Human Pathology: Case Reports.2017; 10: 89.     CrossRef
  • Massive upper gastrointestinal bleeding due to a Dieulafoy’s lesion inside a duodenal diverticulum
    Lucía Relea Pérez, Marta Magaz Martínez, Fernando Pons Renedo
    Revista Española de Enfermedades Digestivas.2017;[Epub]     CrossRef
  • Dieulafoy’s lesion the uncommon cause of upper gastrointestinal bleeding
    Ayman Alsebaey
    Egyptian Liver Journal.2017; 7(3 and 4): 41.     CrossRef
  • Dieulafoy’s lesion of the colon and rectum: a case series and literature review
    Faisal Inayat, Waqas Ullah, Qulsoom Hussain, Hafez Mohammad Ammar Abdullah
    BMJ Case Reports.2017; : bcr-2017-220431.     CrossRef
  • Part 4: Clinical management of an undiagnosed systemic condition
    LaurenE Stone, MarkW Fegley, Rodrigo Duarte-Chavez, Sudip Nanda
    International Journal of Academic Medicine.2017; 3(1): 151.     CrossRef
  • Lower Gastrointestinal Bleeding in Children
    Benjamin Sahn, Samuel Bitton
    Gastrointestinal Endoscopy Clinics of North America.2016; 26(1): 75.     CrossRef
  • Dieulafoy lesion: the little known sleeping giant of gastrointestinal bleeds
    Ramy Saleh, Alan Lucerna, James Espinosa, Victor Scali
    The American Journal of Emergency Medicine.2016; 34(12): 2464.e3.     CrossRef
  • Successful Endoscopic Treatment of an Actively Bleeding Jejunal Dieulafoy's Lesion
    Taiki Aoyama, Akira Fukumoto, Shinichi Mukai, Hiroyuki Ueda, Shigeru Kimura, Shinji Nagata
    Internal Medicine.2016; 55(13): 1739.     CrossRef
  • Hypertension and Clinical Outcomes of Patients With Gastrointestinal Submucosal Vascular (Dieulafoy) Lesional Hemorrhage
    Maen Kamal, Prasanna Santhanam, Yaser M. Rayyan
    The Journal of Clinical Hypertension.2016; 18(7): 710.     CrossRef
  • Endoscopic submucosal dissection for silent gastric Dieulafoy lesions mimicking gastrointestinal stromal tumors
    Xue Chen, Hailong Cao, Sinan Wang, Dan Wang, Mengque Xu, Meiyu Piao, Bangmao Wang
    Medicine.2016; 95(36): e4829.     CrossRef
  • Distinctive aspects of peptic ulcer disease, Dieulafoy's lesion, and Mallory-Weiss syndrome in patients with advanced alcoholic liver disease or cirrhosis
    Borko Nojkov
    World Journal of Gastroenterology.2016; 22(1): 446.     CrossRef
  • Culprit for recurrent acute gastrointestinal massive bleeding: “Small bowel Dieulafoy’s lesions” - a case report and literature review
    Anjana Sathyamurthy, Jessica N Winn, Jamal A Ibdah, Veysel Tahan
    World Journal of Gastrointestinal Pathophysiology.2016; 7(3): 296.     CrossRef
  • Bleeding “Dieulafoy’s-like” lesion resembling the duodenal papilla: a case report
    Mohammad Bilal, Anastasios Kapetanos, Haider Ali Khan, Shyam Thakkar
    Journal of Medical Case Reports.2015;[Epub]     CrossRef
  • 18,640 View
  • 288 Download
  • 52 Web of Science
  • 57 Crossref
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