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

We describe five patients who presented with an acute abdomen in whom pneumoperitoneum was first detected by sonography. All five subsequently were proved to have a perforated viscus. In all cases, the pneumoperitoneum was seen as an echogenic line with a posterior ring-down or reverberation artifact between the anterior abdominal wall and the anterior surface of the liver. The finding was shown best in the right upper quadrant with the patient in the left lateral decubitus position. The echoes caused by the pneumoperitoneum overlapped the echoes of the lung during inspiration, but the echoes were separate during expiration. The probable cause of pneumoperitoneum was determined with sonography in four of the five patients: three had perforation of duodenal ulcer and one had perforation of gastric cancer. The fifth patient had a perforated ileum, which was not evident on the sonogram. Our experience with these patients suggests that the detection of pneumoperitoneum on sonography in patients with an acute abdomen is an important sign of a perforated viscus.
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PMID:Sonographic detection of pneumoperitoneum in patients with acute abdomen. 210 91

We report a case of a male 64 years old with acute abdomen who was operated with the presumptive diagnosis of complicated acute appendicitis. However the patient had black stools for two months, associated with epigastric pain. Endoscopic diagnosis was: Advanced Gastric Cancer: Borrmann II. Histology was informed as: Infiltrating adenocarcinoma intestinal type middlingly differentiated. Surgery findings were: peritonitis with perforated appendicitis in its base: Free coprolites and carcinomatosis. Histology was reported as: ulcerated mucous in caecal appendix, necrosis and perforation of the muscular wall in the base. Mesentery samples were informed with fat tissue involvement by infiltration of tubular adenocarcinoma.middlingly differentiated, suitable with primary gastric cancer.
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PMID:[Complicated acute appendicitis as intercurrent disease in patient with advanced gastric cancer]. 1217 Feb 89

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

A 64-year-old male was referred to our hospital from another hospital for acute abdomen. Emergency laparotomy was performed to confirm an upper gastrointestinal tract perforation. He was diagnosed as a gastric perforation and peritonitis due to a suspected gastric cancer. He underwent omental implantation and peritoneal drainage for peritonitis. Histopathological examination revealed a perforated gastric carcinoma. After the surgery, a liver metastasis was found on the findings of the enhanced abdominal CT scan. Twenty-one days after the emergency surgery, he underwent total gastrectomy with lymphatic dissection and hepatectomy. Eighteen days after the curative surgery, he started to receive postoperative adjuvant chemotherapy. He has been well without recurrence for 2 years and half following the start of chemotherapy.
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PMID:[A case of perforated advanced gastric carcinoma accompanied with single liver metastases, who underwent total gastrectomy and hepatectomy of caudate lobe after drainage operation of peritonitis]. 2122 2

An eighty-year-old female was transferred to the hospital after experiencing abdominal pain and nausea. She had had a history of total gastrectomy for gastric cancer 14 years previously. Abdominal X-ray revealed a localized expansion of the small bowel. Computed tomography revealed a mass with a lamellar structure in a concentric circle. With a tentative diagnosis of small bowel obstruction due to intussusception, she underwent emergency operation. Laparotomy revealed a retrograde jejuno-jejunal intussusception. Bowel resection was performed due to the severe ischemic damage. All reported intussusception cases after total gastrectomy displayed retrograde characteristics and could occur both during the early and late period after surgery. It is important to consider the possibility of intussusception for patients presenting with acute abdomen who have previously undergone gastric resection.
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PMID:Retrograde jejuno-jejunal intussusception after total gastrectomy. 2149 Aug 99

The article presents the case of a male patient, hospitalized due to severe pain in the upper abdomen area, nausea, and vomiting. The patient was diagnosed with surgical acute abdomen, for which emergency surgery is performed. Upon penetration into the peritoneal cavity, stomach inspection shows at the medio-gastric level, on the greater curvature, a callous gastric ulcer, with a central perforation. A large excision is decided up to the healthy (normal) gastric tissue, and the resulting pieces are sent to the pathological anatomy laboratory. The histopathological exam reveals signet ring cell recent gastric carcinoma. The biopsy performed 1 month after surgery, prelevated from the antropyloric zone, reveals antropyloric gastritis with moderate activity and Helicobacter pylori positive. Due to the fact that such cases when this gastric cancer type is diagnosed in recent stages are extremely rare, we considered it useful to present it and look into its macroscopic and microscopic aspects, as well as into the differentiating diagnosis.
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PMID:[Clinical and morphological features in a case of recent gastric carcinoma (the signet ring cell carcinoma type)]. 2185 50

Perforation of gastric cancer is rare and it accounts for less than 1% of the incidences of an acute abdomen. In this study, we reviewed cases of benign or malignant gastric perforation in terms of the accuracy of diagnosis and investigated the clinical outcome after emergency surgery in patients with a free perforation caused by gastric cancer. On the basis of pathological examination, gastric cancer was diagnosed in 8 patients and benign ulcer perforation in 32 patients. The sensitivity, specificity and accuracy of intraoperative diagnosis by pathological examination were 50, 93.8 and 85%, respectively. Except for age, there were no differences in the other demographic characteristics between patients with gastric cancer and benign ulcer perforation. The median survival time of patients with perforated gastric cancer was 195 days after surgery. Patients with gastric cancer perforation had a poorer overall survival rate than those who had T3 tumors without perforation. In addition, in patients with perforation, recurrence of peritoneum occurred more frequently. In conclusion, to improve the survival rate of patients with perforated gastric cancer and to improve the accuracy of intraoperative diagnosis, endoscopic examination and/or pathological examination of the frozen section should be performed, if possible. A balanced surgical strategy using laparoscopic local repair as the first-step of surgery, followed by radical open gastrectomy with lymphadenectomy may be considered.
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PMID:Outcome after emergency surgery in patients with a free perforation caused by gastric cancer. 2313 15

We present the case of a 52-year-old male patient, hospitalized on an emergency basis in the University Emergency Hospital in Bucharest, after being diagnosed with pneumoperitoneum acute abdomen, for which emergency surgery was mandatory. A 3,5-4 cm malignant gastric perforation, ascitis and peritoneal carcinomatosis were found. The histopathological exam revealed infiltrative mucinous gastric carcinoma with epiploic metastasis. Due to the lack of available gastric material, an atypical surgical solution was performed: gastric packing with epiploic material by means of transgastric traction. The solution proved to be successful for short-term recovery. The underlying condition was not focused on, the patient being directed to the Oncology Department. Acute gastric perforation is a rare complication of gastric cancer, and the association with gastric linitis is uncommon. This specific histopathological condition made the classical surgical repair techniques unsuitable for the presented case and an atypical solution had to be performed.
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PMID:Complex histopathological and surgical aspects in a case of giant malignant gastric perforation. 2745 58

BACKGROUND Perforated gastric cancer accounts for less than 1% of patients who present with an acute abdomen and for up to 16% of all gastric perforations. A two-stage laparoscopic procedure may be the therapeutic strategy of choice in selected patients, and adjuvant hyperthermic intraperitoneal chemotherapy (HIPEC) can reduce the incidence of peritoneal recurrence. A rare case of subphrenic abscess and gastric perforation due to carcinoma of the gastric fundus, followed by two-stage gastrectomy and adjuvant HIPEC is presented. CASE REPORT A 65-year old man presented with a left subphrenic abscess secondary to perforated gastric carcinoma. Laparoscopic drainage of the abscess was performed. Ten days later, following recovery from sepsis, the patient underwent total laparoscopic gastrectomy, and adjuvant HIPEC followed by a Roux-en-Y esophagojejunostomy. Histopathology showed an intestinal-type gastric adenocarcinoma. The tumor was staged as pT4aN0. The postoperative course was uneventful except for transient atrial fibrillation. The patient was discharged home on postoperative day 11. Systemic adjuvant chemotherapy was begun one month later. At six-month follow-up, the patient had no discomfort on eating or any other symptoms. CONCLUSIONS In this case, a two-stage laparoscopic treatment for perforated gastric carcinoma combined with adjuvant HIPEC was feasible and safe and may be considered at the time of laparoscopic gastrectomy in selected patients with perforated gastric carcinoma.
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PMID:Drainage of a Subphrenic Abscess Followed by Two-Stage Gastrectomy and Adjuvant Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Perforated Gastric Carcinoma: A Case Report. 3022 53

Malignant acute abdomen is a emergency with abrupt onset, rapid progress and often a complex etiology, presenting difficulties for treatment and high mortality. Therefore, multidisciplinary team (MDT) treatment modality is required. Compared with single-discipline diagnosis and treatment modality, diagnosis made from MDT discussion is more accurate, where specialists can improve efficiency and quality of the treatment through better communication. A good MDT can cover all stages from the diagnosis to the assessment and treatment of the disease, and combine them into a more coherent process. This article discusses the development of radiotherapy-related malignant acute abdomen and the role of radiotherapy in the treatment of malignant acute abdomen from the perspective of oncologic radiotherapy. Common causes of radiotherapy-related acute abdomen from gastric cancer include gastric hemorrhage, upper gastrointestinal obstruction and gastric perforation, while those of radiotherapy-related acute abdomen from colorectal cancer include lower gastrointestinal hemorrhage, intestinal obstruction, intestinal perforation and intestinal fistula. For patients with acute bleeding from gastric cancer that can not be treated by surgery, endoscopic hemostasis or embolization, palliative radiotherapy should be considered. Palliative hypofractionated radiotherapy has the advantage of reducing tumor burden in addition to relieving symptoms of gastric cancer. In patients with acute lower gastrointestinal hemorrhage, as relatively few studies have been established, short course of hypofractionated radiotherapy can be selectively applied. For patients with obstruction, palliative radiotherapy may be considered when surgical assessment is not feasible or tolerable. As malignant acute abdomen has rapid onset and progress, complex etiology and high rate of comorbidity MDT should be fully carried out. For patients with mild symptoms and slow development, radiotherapy can be applied with caution. Emergency treatment such as surgery and intervention should be given when necessary. Passive observation can result in missing the treatment opportunity and should be avoided.
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PMID:[Role of oncologic radiotherapy in multidisciplinary team treatment of malignant acute abdomen]. 3050 30


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