A case of pancreatic cancer invading the superior mesenteric artery causing extensive intestinal necrosis that was successfully treated by surgery

INTRODUCTION: Pancreatic cancer often invades major arteries. However, there are few reports about extensive bowl necrosis caused by superior mesenteric artery (SMA) occlusion associated with pancreatic cancer invasion. CASE REPORT: A 73-year-old woman who was receiving chemotherapy for locally advanced pancreatic cancer (LAPC) was referred to our hospital for abdominal swelling and vomiting that had persisted for 2 days. Contrast-enhanced computed tomography revealed occlusion of the SMA by pancreatic cancer, which had invaded the whole circumference of the SMA. On emergency laparotomy, a large amount of necrotic and ischemic intestine was resected, preserving approximately 100 cm of the ileum. Gastroileostomy was also performed. She had an uneventful postoperative course. CONCLUSIONS: Surgical treatment is a good option for acute SMA occlusion due to invasion by LAPC.