1/139. Metastasis of an esophageal carcinoma to a giant gastric ulcer.In patients with esophageal carcinoma it is considered that stomach metastasis is induced mainly via the lymphatic route rather than via the bloodstream route that is common in other types of distant organ metastasis. A 56 year-old patient is reported who underwent synchronous subtotal esophagectomy and total gastrectomy for a middle third esophageal carcinoma and a giant peptic ulcer within the gastric fundus. The final histopathologic examination revealed a squamous cell carcinoma of the esophagus with concomitant squamous tumor implantation within the gastric ulcer. The increased cell proliferation in the ulcer margin can serve as a "biological background or base" for implantation.- - - - - - - - - - ranking = 1keywords = stomach (Clic here for more details about this article) |
2/139. Non-traumatic liver rupture due to a perforated gastric ulcer.The case of a 57-year-old woman with a fatal liver rupture due to a necrotizing perihepatic abscess caused by a perforated gastric ulcer is presented. The ulcer had been treated successfully by surgical intervention 8 days before. The autopsy revealed a large perihepatic abscess and multiple ruptures of Glisson's capsule with a large subcapsular hematoma and underlying lacerations of the liver parenchyma. The patient had no history of previous abdominal trauma and the known etiological factors for spontaneous liver rupture were excluded by the autopsy findings or by clinical and laboratory data. No liver penetration by the gastric ulcer was found at autopsy and there were no clinical signs or symptoms for an infection or any degenerative or inflammatory diseases. Histologically abundant vegetable fibers, identified as stomach contents and a dense infiltrate of lymphocytes and granulocytes were found in the perihepatic abscess next to Glisson's capsule. Below Glisson's capsule there were hemorrhages, focal hepatocellular necrosis and a mixed cell inflammatory infiltration. In the present case, preceding perforation of the gastric ulcer with leaking of gastric acid into the peritoneal cavity resulted in peptic digestion of Glisson's capsule. Vascular lesions of the affected parts of Glisson's capsule and the liver parenchyma underneath resulted in intrahepatic hemorrhage and an increase in intrahepatic pressure with subsequent liver rupture. To the authors' knowledge no similar case of spontaneous liver rupture due to perforation of a gastric ulcer has been reported previously.- - - - - - - - - - ranking = 1keywords = stomach (Clic here for more details about this article) |
3/139. 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 (Clic here for more details about this article) |
4/139. Left diaphragmatic hernia complicated by perforation of an intrathoracic gastric ulcer into the aorta: report of a case.We describe herein a rare but fatal complication of diaphragmatic hernia that occurred in a 51-year-old man 3 years after his diaphragm had been repaired by a polytetrafluoroethylene sheet following resection during pleuropneumonectomy for a left pleural mesothelioma. He was admitted to our hospital in shock status, and was found to have massive bleeding from the nasogastric tube. An emergency operation revealed that an ulcer of the stomach, which had been displaced into the left thorax, had perforated directly into the descending aorta.- - - - - - - - - - ranking = 1keywords = stomach (Clic here for more details about this article) |
5/139. A case of esophageal carcinoma surgically treated after discontinuance of the simultaneous application of radiotherapy and chemotherapy with low doses of CDDP and 5-FU.The patient, a 69-year-old man with esophageal cancer, had a type 2 tumor in the Mt region, accompanied with an ulcer measuring 12 cm in the major axis. In addition, lymph node metastasis, approximately 5x4 cm, was observed in the lesser curvature of the stomach. The clinical stage of the lesion was T3N1M0 (stage III), and simultaneous therapy combining radiotherapy (2 Gy/day) with chemotherapy employing CDDP (6 mg/day) and 5-FU (300 mg/day) was started on October 21, 1996. During treatment, tumor invasion into the gastric walls from lymph node metastasis was observed on endoscopy, and radiotherapy was discontinued at a total dose of 40 Gy to avoid the possibility of bleeding. Surgery was performed on January 8, 1997. Although tumor invasion from lymph node metastasis in the lesser curvature of the stomach was observed in the pancreas, no remaining cancer cells were noted in the primary nest and metastasized lymph node, suggesting the usefulness of the simultaneous combined therapy.- - - - - - - - - - ranking = 2keywords = stomach (Clic here for more details about this article) |
6/139. Isolated gastric tuberculosis presenting as massive hematemesis: report of a case.Tuberculous involvement of the stomach is rare. We report herein the unusual case of a 25-year-old man in whom a benign gastric ulcer was found along the lesser curvature after he presented with massive upper gastrointestinal bleeding. Histopathological examination helped to confirm a diagnosis of tuberculosis. The granulomas typical of tuberculosis were caseation with epithelioid and giant cells. The patient was successfully treated by a combination of appropriate surgical therapy and prompt institution of antituberculosis medication.- - - - - - - - - - ranking = 1keywords = stomach (Clic here for more details about this article) |
7/139. Mott cell tumor of the stomach with helicobacter pylori infection.A plasma cell tumor of the stomach with unusual histology is reported. Macroscopically, the tumor formed two ulcers in the gastric body, and microscopic examination revealed proliferation of plasma cells producing immunoglobulin g kappa monotypic immunoglobulin, with metastatic infiltration in some perigastric lymph nodes. Most of these plasma cells had various-sized Russell bodies in the cytoplasm; hence the tumor may be called Mott cell tumor. The Russell bodies showed a strong affinity to concanavalin a by lectin immunohistochemistry, compared with those in reactive Mott cells. In addition, helicobacter pylori (H. pylori) infection was proved by Gimenez stain and immunohistochemistry. The mixture of some centrocyte-like cells and presence of reactive lymph follicles with follicular colonization by tumor cells suggest that this lesion may be a variant of mucosa-associated lymphoid tissue lymphoma in association with H. pylori infection. The patient has shown no evidence of recurrence of the tumor after 11 years of follow up.- - - - - - - - - - ranking = 5keywords = stomach (Clic here for more details about this article) |
8/139. Recurrent metastatic renal cell carcinoma presenting as a bleeding gastric ulcer after a complete response to high-dose interleukin-2 treatment.immunotherapy with high-dose recombinant interleukin-2 is an effective therapy for selected patients with metastatic renal cell carcinoma (RCC). Objective responses (complete or partial) are observed in about 15% of treated patients. The overall and disease-free survival of patients with a complete response are significantly prolonged. Although RCC is known to spread hematogenously, isolated RCC metastasis to the stomach is a rare event. Recurrent RCC, after a complete response to interleukin-2, presenting clinically as an isolated gastric metastasis, has not been reported to date. In this report, we describe the clinical course of a patient with metastatic RCC who had a complete response to high-dose interleukin-2 and was disease free for 4 years before presenting with massive upper gastrointestinal hemorrhage due to an isolated gastric metastasis. The patient remained disease free for 3 years after resection of the metastasis. Metastatic RCC to the stomach, although rare, should be suspected in any patient with a history of RCC who presents with gastrointestinal symptoms. In the absence of diffuse disease, aggressive therapy, including surgical resection, is appropriate for isolated gastric metastasis, because prolonged survival is possible.- - - - - - - - - - ranking = 2keywords = stomach (Clic here for more details about this article) |
9/139. Gastric tuberculosis presenting as non-healing ulcer: case report.Tuberculous infection of the stomach is uncommon and the diagnosis is often missed due to its non-specific presentation. We report a case of gastric tuberculosis which presented as a non-healing gastric ulcer.- - - - - - - - - - ranking = 1keywords = stomach (Clic here for more details about this article) |
10/139. One-month-old infant with multiple ulcers of stomach, small bowel, large bowel, and protein-losing enteropathy: case report.Multiple inflammatory ulcers of the gastrointestinal tract are rare in young infants. Most cases are caused by infectious organisms, vasculitis, or an autoimmune process. We report a 1-month-old infant who was healthy until he presented with an inflammatory mesenteric cyst, and multiple ulcers of the stomach, duodenum, jejunum, ileum, and colon. Histologically, the ulcerations were sharply demarcated, full thickness, and filled with macrophages. He had a low serum albumin and IgG due to protein-losing enteropathy. He was treated with supportive care and immunomodulating drugs. The gastrointestinal inflammation resolved by 3 and 1/2 years of age. The medications were withdrawn at 5 and 1/2 years of age he had no relapse of clinical symptoms. He continues to have asymptomatic mild hypoalbuminemia and low serum IgG. We could not find a report of a similar clinical presentation and outcome.- - - - - - - - - - ranking = 5keywords = stomach (Clic here for more details about this article) |
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