1/21. Unusual gastrointestinal features in a child with pernicious anemia.Pernicious anemia in childhood is a rare disease. The radiologic demonstration of gastric mucosal atrophy led directly to this diagnosis in an 11-year-old girl. In addition, there was deformity of the pyloric antrum and superficial ulceration in the stomach and duodenum. endoscopy and biopsy confirmed these findings.- - - - - - - - - - ranking = 1keywords = stomach, ulcer (Clic here for more details about this article) |
2/21. Gastric carcinoid tumours and pernicious anemia: case report and review of the literature.patients with pernicious anemia are at risk of developing carcinoid tumours of the stomach. A patient with pernicious anemia and multifocal carcinoid tumours of the gastric fundus that regressed after antrectomy is presented. The frequent occurrence of gastric carcinoid tumours in patients with long-standing pernicious anemia suggests that surveillance gastroscopy and biopsies of the fundus might be indicated. Compete functional antrectomy may effectively cause these tumours to regress by removing their excessive gastrin hormonal stimulation. However, incomplete antrectomy can result in persistently elevated serum gastrin and failure of total disappearance of the carcinoid tumours.- - - - - - - - - - ranking = 0.72772903453729keywords = stomach (Clic here for more details about this article) |
3/21. Benign gastric ulcer in a patient with pernicious anemia.This is the report of the presence of a benign gastric ulcer in a patient with achlorhydria and documented pernicious anemia. The pernicious anemia was established by a Histalog-fast achlorhydria, a schilling test of 2.1% excretion of tagges vitamin B12 in a 24-hr urine, and reticulocytosis after administration of cyanocobalamine. Following Histalog (1.5 mg per kg of body weight), the gastric volume was 40 ml, there was no acid, and the pH was 8.1. The ulcer demonstrated by gastroscopy was confirmed at gastrectomy. Histological examination of the ulcer and the remainder of the stomach showed no malignancy. The principal conclusion of this paper is that the patient did not have an acid-produced ulcer, but that bile regurgitation coupled with alcohol ingestion produced the lesion. Surgical investigation of the ulcer seemed mandatory because of the known increased incidence of gastric carcinoma in patients with pernicious anemia.- - - - - - - - - - ranking = 157.09667235141keywords = gastric ulcer, stomach, ulcer (Clic here for more details about this article) |
4/21. gastric antral vascular ectasia associated with gastric carcinoma.gastric antral vascular ectasia (GAVE), or watermelon stomach, is an uncommon cause of chronic gastrointestinal blood loss and iron deficiency anemia. Although GAVE has not previously been reported in association with gastric cancer, it is often associated with atrophic gastritis and pernicious anemia, which are known risk factors for gastric malignancy. We report a 72-yr-old woman with pernicious anemia who was found to have GAVE associated with adenosquamous carcinoma of the gastric cardia and adenocarcinoma in situ of the pylorus. In view of recent reports of the use of endoscopic modalities rather than surgical resection to treat GAVE, our case alerts endoscopists to the possibility of coexisting carcinoma.- - - - - - - - - - ranking = 0.72772903453729keywords = stomach (Clic here for more details about this article) |
5/21. Neuroendocrine tumor of the pancreas in a patient with pernicious anemia.A total of 71 patients has been reported in the English literature to have developed carcinoid tumors in the fundus of the stomach in association with chronic atrophic gastritis secondary to pernicious anemia. The tumors appear to develop from argyrophilic cells in response to hypergastrinemia produced by hyperplastic G cells in the antrum of the stomach. We report a similar patient who, in addition, had a neuroendocrine tumor develop in the neck of the pancreas, which obstructed the pancreatic duct and resulted in severe chronic pancreatitis in the body and tail of the gland. There was an associated splenic vein thrombosis with left-sided portal hypertension. The pancreatic neoplasm was treated by excision, including the caudal 85 per cent of the pancreas and spleen. The gastric carcinoids appeared to diminish in size in response to a octreotide acetate (Sandostatin, Sandoz Pharmaceuticals; Hanover, NJ) administered to promote closure of a low-volume postoperative pancreatic fistula. The gastric lesions may require surgical treatment in the future. We were unable to find other examples of pancreatic neuroendocrine tumor occurring in association with pernicious anemia in a search of the English literature.- - - - - - - - - - ranking = 1.4554580690746keywords = stomach (Clic here for more details about this article) |
6/21. Benign gastric ulcers and pernicious anemia.The formation of a benign gastric ulcer in an achlorhydric milieu is a rare phenomenon. Since 1971, only 12 cases have been reported. Early cases were treated surgically for fear of gastric cancer, but since that time such ulcers have been successfully treated medically. The authors describe the case of a patient who had no concomitant ulcerogenic factors and whose ulcer occurred in the gastric cardia at the esophagogastric junction. We believe this is the first case report of a patient with pernicious anemia meeting these conditions.- - - - - - - - - - ranking = 156.09667235141keywords = gastric ulcer, ulcer (Clic here for more details about this article) |
7/21. Multicentric gastric carcinoids complicating pernicious anemia. Origin from the metaplastic endocrine cell population.We report three cases of multicentric carcinoid tumors of the stomach in patients with long-standing pernicious anemia and severe atrophic gastritis (type A). The tumor nodules arose in nonantral gastric mucosa showing marked intestinal metaplasia. Diffuse endocrine cell hyperplasia was present in both fundus and antrum. Antral G-cell hyperplasia was observed. A widely accepted pathogenesis of this syndrome suggests that the proliferating cell type is the argyrophilic, enterochromaffinlike cell native to the gastric body and fundus. Our findings conflict with this view, in that focal argentaffin staining was also present within tumor cells, as well as immunoreactivity for serotonin and substance p (more characteristic of small-intestinal enterochromaffin or Kulchitsky's cells and small-intestinal carcinoids). Findings in these cases at least suggest an alternative possibility: the tumors may derive from small-intestinal-type metaplastic endocrine cells within the atrophic mucosa, rather than the hypertrophic native endocrine cell population.- - - - - - - - - - ranking = 0.72772903453729keywords = stomach (Clic here for more details about this article) |
8/21. Multifocal gastric carcinoid tumours, achlorhydria, and hypergastrinaemia.Multiple polypoidal carcinoid tumours of the stomach were found in 5 patients with achlorhydria (4 of whom had pernicious anaemia) as a result of autoimmune atrophic gastritis. The tumours were small (nearly all less than 1 cm diameter) and appeared to grow very slowly, if at all; no significant enlargement or complications were seen during periods of observation of up to 6 years. No extragastric hormonal syndromes were identified. They differed from the carcinoid tumours usually found in the intestinal tract by being composed of argyrophil (not argentaffin) cells of the enterochromaffin-like (ECL) type. fasting plasma levels of gastrin, which is believed to be trophic to ECL cells, were very high in all patients. Thus, chronic hyperplasia of gastric ECL cells (as a result of hypergastrinaemia) may have been responsible for development of the tumours. Long-term, uninterrupted achlorhydria produced by potent inhibitors of gastric acid secretion might therefore predispose to carcinoid tumours of the stomach.- - - - - - - - - - ranking = 1.4554580690746keywords = stomach (Clic here for more details about this article) |
9/21. Intestinal metaplasia of the stomach confined to the fundic gland area. Report of two cases.Two patients with intestinal metaplasia of the stomach, whose distribution was exclusively confined to the fundic gland area, are presented herein. The first, a 51-year-old male, had been treated for pernicious anemia for 14 years when he was found to have gastric cancer. His serum gastrin level was quite high, whereas his gastric acid output was markedly low. The polypoid cancer in the fornix of the stomach, which had been removed endoscopically, revealed tubular adenocarcinoma with its invasion limited to the mucosa. The resected stomach showed no residual carcinoma but had numerous minute foci of intestinal metaplasia, diffusely distributed but exclusively confined to the fundic gland area, by macroscopic observation using the leucine aminopeptidase-alkaline phosphatase double staining method. The intestinal metaplasias were all of the complete type, and the parietal and chief cells were almost completely lost. The second patient, a 76-year-old male without pernicious anemia, underwent total gastrectomy for two polypoid cancers in the body of the stomach. The resected specimens, in addition to two hyperplastic polyps in the transitional area, showed the same distribution of intestinal metaplasia as seen in the first patient.- - - - - - - - - - ranking = 5.8218322762983keywords = stomach (Clic here for more details about this article) |
10/21. Juvenile onset pernicious anemia, partial intestinal villous atrophy, ulcerative colitis, and squamous metaplasia of the stomach.We report a case of a 13-yr-old white boy with juvenile onset pernicious anemia in association with igg deficiency. He had marked gastric atrophy, intestinal metaplasia of the stomach, and an intractable antral ulcer that required surgery. In addition, his gastric mucosa showed evidence of a progressive squamous metaplasia. Diffuse squamous metaplasia of the stomach, a very rare gastric lesion, has not previously been described either in association with pernicious anemia, atrophic gastritis, or hypogammaglobulinemia. This patient also has ulcerative colitis involving the entire colon and partial villous atrophy noted on small intestinal biopsy.- - - - - - - - - - ranking = 6keywords = stomach, ulcer (Clic here for more details about this article) |
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