Stomach cancer complicated by perforation and acute bleeding
Abstract
improvement and optimization of diagnosis and treatment of gastric cancer complications. 56 patients with gastric cancer complications were treated. The average age of the patients was 56 years. Of them, 13 (23.21%) were women amd 43 (76.79%) were men. During comprehensive diagnostic and therapeutic monitoring, it was found that 15 patients (26.79%) had gastrointestinal bleeding, 12 patients (21.43%) had gastric stenosis of various degrees, and the remaining 29 patients (51.79%) gastric cancer complicated by gastric perforation, of them, in 21 patients, perforation was accompanied by bleeding. Age and gender, preoperative diagnosis, localization of perforation, depth of gastric wall invasion, absence or presence of metastases in lymph nodes, type of operation, degree of lymphatic dissection, stage and complications were studied. The percentage of complications in the form of perforation among gastric cancer was 51.79%. The disease was more common in stage III/IV (70%). Operations performed: gastrectomy in 16 patients and suturing of perforation in 10 patients. Death related to surgery was observed in 4 patients. 10 subtotal gastrectomies and 6 total gastrectomies were performed. In 15 patients, clinically pronounced gastrointestinal bleeding was observed, which was manifested in the form of melena, hematemesis or in the form of melena and hematemesis simultaneously (2.5%). The mean age was 68 ± 12 (range 47–87). A complication in the form of gastric stenosis was detected in 12 patients (21.43%). During the study, subcompensated stenosis of the pyloric part of the stomach was detected in 5 patients, decompensated stenosis in the remaining patients. The choice of surgical intervention method was carried out individually, depending on the patient's condition, the degree of stenosis and the nature of pathomorphological changes, the state of the secretory and motor function of the stomach, the presence of accompanying pathology and the stage of gastric cancer. In this group of patients, there is 1 case of mortality, which was due to IV stage of gastric cancer and decompensated stenosis with pronounced disorders of water-electrolyte balance and acid-base balance.
References
Carney, B. W., Khatri, G., & Shenoy-Bhangle, A. S. (2019). The role of Imaging in Gastrointestinal Bleed. Cardiovascular Diagnosis and Therapy, 9(S1). https://doi.org/10.21037/cdt.2018.12.07
Cho, S. B., Park, S. E., Lee, C. M., Park, J.-H., Baek, H. J., Ryu, K. H., Moon, J. I., Choi, B. H., Ha, J. Y., & Lee, S. (2018). Splenic artery pseudoaneurysm with splenic infarction induced by a benign gastric ulcer. Medicine, 97(29). https://doi.org/10.1097/md.0000000000011589
Crisan, D., Tantau, M., & Tantau, A. (2014). Endoscopic management of bleeding gastric varices—an updated overview. Current Gastroenterology Reports, 16(10). https://doi.org/10.1007/s11894-014-0413-1
Erhunmwunsee, L., & Lagoo-Deenadayalan, S. A. (2009). Urgent workup for upper gastrointestinal bleeding. Gastrointestinal Bleeding, 13–22. https://doi.org/10.1007/978-1-4419-1693-8_2
Grippi, F. J., & Yu, H. (2018). Acute upper gastrointestinal hemorrhage from a pseudoaneurysm of an unusual superior polar artery of the spleen. Radiology Case Reports, 13(4), 797–800. https://doi.org/10.1016/j.radcr.2018.05.006
Holster, I. L., den Hoed, C. M., & Kuipers, E. J. (2011). Peptic ulcer bleeding: Endoscopic diagnosis, endoscopic therapy and pharmacotherapy. Gastrointestinal Bleeding, 41–77. https://doi.org/10.1002/9781444398892.ch4
Jesinger, R. A., Thoreson, A. A., & Lamba, R. (2013). Abdominal and pelvic aneurysms and Pseudoaneurysms: Imaging Review with clinical, radiologic, and treatment correlation. RadioGraphics, 33(3). https://doi.org/10.1148/rg.333115036
Kawabata, H., Hitomi, M., & Motoi, S. (2019). Management of bleeding from unresectable gastric cancer. Biomedicines, 7(3), 54. https://doi.org/10.3390/biomedicines7030054
Kim, Y.-I., & Choi, I. J. (2015). Endoscopic management of tumor bleeding from inoperable gastric cancer. Clinical Endoscopy, 48(2), 121. https://doi.org/10.5946/ce.2015.48.2.121
Laine, L. (2016). Upper gastrointestinal bleeding due to a peptic ulcer. New England Journal of Medicine, 374(24), 2367–2376. https://doi.org/10.1056/nejmcp1514257
Lau, L.H.S. and Sung, J.J.Y. (2021), Treatment of upper gastrointestinal bleeding in 2020: New techniques and outcomes. Digestive Endoscopy, 33: 83-94. https://doi.org/10.1111/den.13674
Lin, H.-J., Perng, C.-L., Lee, F.-Y., Chan, C.-Y., Huang, Z.-C., Lee, S.-D., & Lee, C.-H. (1993). Endoscopic injection for the arrest of peptic ulcer hemorrhage: Final results of a prospective, randomized comparative trial. Gastrointestinal Endoscopy, 39(1), 15–19. https://doi.org/10.1016/s0016-5107(93)70003-6
Little, D. H. W., Robertson, T., Douketis, J., Dionne, J. C., Holbrook, A., Xenodemetropoulos, T., & Siegal, D. M. (2021). Management of antithrombotic therapy after gastrointestinal bleeding: A mixed methods study of health‐care providers. Journal of Thrombosis and Haemostasis, 19(1), 153–160. https://doi.org/10.1111/jth.15111
Matei, D. (2017). Peptic Ulcer Bleeding in the Elderly: Clinical Outcomes and in-Hospital Mortality . https://doi.org/10.26226/morressier.59a6b34cd462b80290b55c68
Pichaichanlert, A., Luvira, V., & Tipsunthonsak, N. (2017). Abdominal pregnancy in the small intestine presenting as acute massive lower gastrointestinal hemorrhage. Case Reports in Surgery, 2017, 1–4. https://doi.org/10.1155/2017/8017937
Pietrabissa, A., Ferrari, M., Berchiolli, R., Morelli, L., Pugliese, L., Ferrari, V., & Mosca, F. (2009). Laparoscopic treatment of splenic artery aneurysms. Journal of Vascular Surgery, 50(2), 275–279. https://doi.org/10.1016/j.jvs.2009.03.015
Wells, M. L., Hansel, S. L., Bruining, D. H., Fletcher, J. G., Froemming, A. T., Barlow, J. M., & Fidler, J. L. (2018). CT for evaluation of acute gastrointestinal bleeding. RadioGraphics, 38(4), 1089–1107. https://doi.org/10.1148/rg.2018170138
This work is licensed under a Creative Commons Attribution 4.0 International License.
ISSN 
ISSN 
