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a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2019; 73(3): 243–249. doi:10.14735/amgh2019243.

Metastasis to the stomach and duodenum as an unusual cause of acute bleeding in the upper gastrointestinal tract

Lucia Farská1, Martin Rychtařík2, Miroslav Řežábek3

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Bleeding in the upper digestive tract is one of the most serious conditions in gastroenterology and is associated with relatively high mortality. Although endoscopic techniques have rapidly developed, this bleeding requires fast and accurate diagnosis together with rapid and effective treatment, which necessitates the collaboration of gastroenterologists and surgeons. There are many causes of gastrointestinal bleeding. Malignant lesions are responsible in only a small percentage of cases. Metastases to the upper gastrointestinal tract from distant organs are rare and consequently often represent an advanced stage of malignancy. Clinical cases of metastasis to the upper gastrointestinal tract are highly nonspecific and endoscopic imaging is often heterogeneous. Lung, breast, and renal carcinomas most often metastasize to the stomach, while melanoma and lung, renal, cervical, and thyroid carcinomas can metastasize to the duodenum. This study describes two cases with this rare cause of acute bleeding in the upper gastrointestinal tract. The first case was a patient with metastasis of breast cancer to the stomach fornix. In the second case, metastasis of renal carcinoma to the duodenum via the head of the pancreas was the source of acute bleeding in the upper digestive tract. Treatment of metastatic tumors in the stomach and duodenum is palliative in most cases, depends on the overall condition of the patient and the type of primary carcinoma, and consists of various combinations of endoscopic, radiological, surgical, and oncological interventions.


duodenum, gastrointestinal bleeding, breast cancer, metastasis, renal carcinoma, stomach

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