Studies have been recently conducted to find pancreatic ductal adenocarcinoma (PDAC) in high-risk groups by identifying individuals with pancreatic cystic lesions and elderly people (> 50 years) with new-onset diabetes mellitus (NODM). We report the case of a 91-year-old woman in good health with pancreatic cysts, who firstly displayed a NODM and, one month later, a PDAC. A dehydration syndrome with polydipsia and asthenia led to her hospitalization. High levels of blood glucose and glycated hemoglobin were found. An abdomen US showed a minute pancreas with some cysts. Rehydration and insulin therapy led to a good glycemic compensation. One month after discharge, she displayed weight loss, diarrhea, and jaundice. On the second admission, high levels of total and direct bilirubin, indices of hepatic cholestasis, and Ca 19.9 were found. An abdomen contrast medium CT evidenced a nodule at the pancreatic head, suggesting a malignant lesion, and dilatation of both the Wirsung duct an
The authors present the case of an 80-year-old female with myelodysplastic syndrome treated with chemotherapy and apixaban, a direct oral anticoagulant who suffered an intracranial hemorrhage. She presented to the emergency department with altered mental status and was found to have a large intraparenchymal hematoma with a significant mass effect. Our patient was given FEIBA (Factor Eight Inhibitor Bypass Activity) to reverse the hemorrhage. Anticoagulant-related bleeding reversal strategies are discussed.