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Query: UMLS:C0024623 (gastric cancer)
 36,219 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ultrasonography (US) is often the first imaging study performed in patients with abdominal pain or vague symptoms related to the gastrointestinal tract. An awareness of the US appearances of diseases of the intestine is essential to achieve the proper diagnosis and to enable appropriate triage of cases. Pathologic processes that affect the intestine generally result in decreased peristalsis and bowel wall thickening, both of which tend to decrease the luminal gas content. These changes permit evaluation of the intestine and surrounding structures with transabdominal and transvaginal US. US is useful in diagnosis of infectious and inflammatory conditions, such as appendicitis, Crohn disease, diverticulitis, epiploic appendagitis, pseudomembranous colitis, small bowel obstruction, small bowel vasculitis, and celiac disease. US is also helpful in diagnosis of tumors, such as gastric cancer, bowel lymphoma, and colon cancer. Familiarity with the US appearances of diseases that affect the intestine may allow specific diagnosis based on the degree and distribution of bowel wall thickening and associated changes of the perienteric tissues.
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PMID:US of gastrointestinal tract abnormalities with CT correlation. 1253 41

Authors operated on 416 patients for gastric cancer between 1st of June 1991 and 31st of May 2001. Among them 305 lesions were resectable. So the resection rate was 73.3 per cent. Gastrectomy was performed in 161 patients (52.8 per cent of resections). Total gastrectomy with omentectomy was performed in 44 patients. In 96 patients splenectomy, in 19 patients splenectomy with the resection of the left side of the pancreas, in 33 patients distal esophageal resection and in 8 patients other organ resection was performed with total gastrectomy. Standard, two field lymphadenectomy has been performed only in the past few years. Uneventful recovery followed in 100 cases (62 per cent), 61 patients (38 per cent) suffered complications in the postoperative period. The most frequent surgical complication was anastomotic leak, which was observed in 8 patients (5 per cent). Septic complications, intraluminal bleeding, postoperative pancreatitis, intraabdominal bleeding, pancreatic fistula and small bowel obstruction were the most frequent surgical complications. Most general complications occurred in the cardiorespiratory system. In 9 patients reoperation was necessary. Eight patients (5 per cent) died in the postoperative period. In patients with extended gastrectomy significantly more complications occurred--compared with gastrectomy + omentectomy only. This could also be observed in patients with only splenectomy. If more organs were removed or resected with total gastrectomy and splenectomy, the complication rate increased only if pancreatic resection was performed. Mortality rate increased in these patients as well. The esophageal or other neighbouring organ (colon, small-bowel, liver, diaphragm etc.) resection had no influence on the postoperative morbidity or mortality. Extended operations should be performed, as the risk is acceptable, if there is hope for tumour clearance.
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PMID:[Effect of extending the resection on postoperative complications of total gastrectomies: experience with 161 operations]. 1261 21

A 47-year-old woman underwent curative resection of advanced gastric cancer, followed by continuous hyperthermic peritoneal perfusion (CHPP). She was readmitted to our hospital 6 months after the operation with a diagnosis of postoperative adhesional ileus. An exploratory laparotomy revealed that the small intestine, which had normal serosa, was folded and enveloped in thickened peritoneum like a "cocoon," suggesting sclerosing encapsulating peritonitis (SEP). Because of tight adhesion in the ileocecal region, resection of the membrane was performed only in the feasible areas, followed by side-to-side anastomosis between the ileum and ascending colon. The patient has remained well for 15 months since this operation with no radiological signs or laboratory findings of recurrence. When small bowel obstruction does not show improvement with conservative treatment, and if the possibility of peritoneal cancer recurrence is excluded by thorough examinations, it is important to perform laparotomy early to resolve the symptoms of bowel obstruction and restore the patient's quality of life.
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PMID:Sclerosing encapsulating peritonitis (SEP) as a delayed complication of continuous hyperthermic peritoneal perfusion (CHPP): report of a case. 1265 94

A 44-year-old male patient underwent total gastrectomy for gastric cancer with peritoneal dissemination and direct invasion into the pancreas. After the operation, the patient received daily oral administration of TS-1, a novel oral anticancer agent. Each treatment course consisted of four-week administration of 120 mg TS-1 daily followed by two drug-free weeks. The patient was confirmed to be cancer-free by abdominal CT from the eighth course. With this chemotherapy, slight decrease of WBC (grade 1 or 2) and mild bowel obstruction appeared as the side effects of TS-1, but no other serious effects were observed. (A dose reduction of TS-1 from 120 mg to 100 mg per day was done at the beginning of the fifth course.) This patient could return to his work (physical labor) in the sixth month after the operation. The cancer-free period has persisted for sixteen months since the operation, and a good quality of life has been maintained simultaneously. TS-1 revealed a high effectiveness without deteriorating the patient's quality of life.
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PMID:[A case report of adjuvant chemotherapy (TS-1) for far advanced gastric cancer in which the patient maintained a good quality of life]. 1266

We herein report a rare complication of the migration of a feeding jejunostomy tube through the entire intestine. A surgical Stamm jejunostomy was performed in a patient with an unresectable gastric cancer using a 28-F silicone catheter with a mushroom tip (Pezzer catheter). The catheter was suture-fixed to the skin, family members were given instructions regarding tube feeding and tube care, and the patient was discharged to home care. Two months later, he presented because of the "disappearance" of the tube. A clinical examination revealed a mature jejunostomy tract, skin erosion at the site where the suture was placed, and absence of the tube. There were no signs of intestinal obstruction or peritonitis. Abdominal X-ray examination showed the catheter inside the jejunum. The patient was treated conservatively with serial radiographs showing rapid tube migration through the intestine, and the tube was eliminated spontaneously 5 days later. An awareness of this complication and its appropriate treatment is important given the widespread use of enteral nutrition.
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PMID:Enteral migration of a Pezzer tube after a feeding jejunostomy: report of a case. 1288 2

Many complications frequently occur in gastric cancer patients which require urgent treatment. Oncologic emergencies in gastric cancer vary widely and include hemorrhage, perforation and obstruction due to gastric cancer tumors, obstructive jaundice, hydronephrosis, intestinal obstruction and disseminated intravascular coagulation due to advanced metastatic, recurrent, or systemic tumors, and adverse effects secondary to chemotherapy. In gastric cancer treatment, we must recognize the occurrence of oncologic emergencies resulting from gastric cancer progression and recurrence. It is important that the knowledge of advanced stages and the prognosis of gastric cancer patients be taken into consideration when treating patients in a critical state.
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PMID:[Oncologic emergencies in gastric cancer patients]. 1511 89

We report 3 gastric cancer patients with peritoneal dissemination who failed to take TS-1 due to adverse effects and who were successfully treated with weekly paclitaxel administered intravenously. The patients were 2 men and 1 woman from 73 to 82 years in age. The histological types of gastric cancer were undifferentiated adenocarcinoma in all cases. Intravenous infusion of TXL (62-80 mg/m2) after short premedication was continued for 3 weeks followed by 1 week rest. Clinical symptoms, including ascites and intestinal obstruction, improved only after administration of 1 cycle in all patients. Except for 1 event with grade 3 neutropenia, no major adverse reactions were observed. Weekly administration of paclitaxel may be a promising chemotherapy for controlling peritoneal metastasis and improving the quality of life of patients with advanced or recurrent gastric cancer.
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PMID:[Efficacy of weekly administration of paclitaxel for advanced or recurrent gastric cancer with peritoneal dissemination]. 1517 Sep 88

A 79-year-old man was admitted for advanced transverse colon cancer with large bowel obstruction. Twelve years earlier he underwent a total gastrectomy with Roux-en Y reconstruction for gastric cancer. No metastasis was detected preoperatively. Exploratory laparotomy revealed massive direct invasion of the mesenterium of the jejunum for Roux-en Y reconstruction. The primary lesion was unresected and transverse colostomy was made. Systemic chemotherapy with 5-fluorouracil and l-leucovorin was scheduled for a total of 4 courses postoperatively. After completion of this chemotherapeutic regimen, a CT scan and colonofiberscopy revealed the primary lesions had disappeared, and a histological examination of biopsy confirmed that the patient had achieved a complete remission (CR). There was no severe side effect during chemotherapy. The patient is presently enjoying a good general condition and has been free from any sign of recurrence.
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PMID:[A case of advanced colon cancer responding completely to systemic 5-fluorouracil/l-leucovorin therapy]. 1557 Sep 38

Malignant chronic bowel obstruction (MCBO) is a syndrome caused by abdomen-pelvic diffusion of neoplastic diseases of any origin. It generally occurs in an advanced disease, affecting 3-15% of patients recently operated, untreated, or submitted to radiotherapy. Patients complain of chronic pain and vomitus. The approach to this problem is multidisciplinary, involving the surgeon, the endoscopist, the oncologist, and the pain-therapy expert. Direct percutaneous jejunostomy (DPEJ) using a percutaneous endoscopic gastrostomy (PEG) tube is a jejunal percutaneous access procedure indicated for nutrition in those patients whose stomach cannot be used, as in cases of partially or totally gastrectomized ones. A venting PEG or percutaneous endoscopic jejunostomy (PEJ) is a solution to drain the gastrointestinal tract for MCBO even in difficult cases represented by patients with previous abdominal surgery, those with partial or total gastrectomies, ascites, or peritoneal carcinosis. We report our five-case experience of draining an MCBO in patients previously operated on for gastric cancer, using a DPEJ technique that we believe is the best technique for this purpose.
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PMID:Venting direct percutaneous jejunostomy (DPEJ) for drainage of malignant bowel obstruction in patients operated on for gastric cancer. 1571 47

Postoperative enteral nutrition is a widely accepted route of application for nutrition formulas due to a low complication rate, a good acceptance by patients. and a favorable cost-effectiveness. We report three cases of bezoar ileus after early postoperative enteral nutrition, using a fine needle jejunostomy (FNJ) in two cases and a nasoduodenal tube in one case. A male patient who underwent gastric resection for a gastrointestinal stroma tumor and was nourished through an fine needle jejunostomy developed an acute abdomen on the seventh postoperative day. Surgical exploration revealed a mechanical ileus caused by denaturated nutrition formula distal to the catheter tip. The second case, a female patient, underwent gastric resection for a gastric cancer and on the fourth postoperative day developed acute onset of abdominal pain. Intraoperative findings were the same as described in the first case. The third case, a male patient with necrotizing cholecystitis, underwent open cholecystectomy. Postoperative enteral feeding was performed using a nasoduodenal tube. He developed a small bowel obstruction on the 17th postoperative day that was caused by an intraluminal bezoar. In conclusion, bezoar formation represents an underestimated complication of postoperative enteral feeding. Acute onset of abdominal pain and the development of small bowel obstruction are the main clinical symptoms of this severe complication. The pathogenesis of bezoar formation remains unclear.
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PMID:Postoperative bezoar ileus after early enteral feeding. 1636 1


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