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Gastric Cancer Revealed by a Perforated Ulcer: A Case Report and Review
- Source :
- Surgical Science. 11:399-404
- Publication Year :
- 2020
- Publisher :
- Scientific Research Publishing, Inc., 2020.
-
Abstract
- Introduction: Gastric cancer is not typically a surgical emergency. However, it can evolve into urgent complications such as a perforation. We report a case of a perforated gastric ulcer that turned out to be a cancer. Observation: A 52-year-old man was admitted to the emergency department of Hubert-Koutoukou-Maga National University Medical Center in Cotonou for generalized abdominal pain. He was diagnosed with acute generalized peritonitis with perforated gastric ulcer, establishing a surgical indication. An antral perforation was found and a simple closure was performed. Anatomopathological examination of the surgical piece revealed a gastric adenocarcinoma within the granulation tissue. Following the impact assessment, he underwent a second surgery where a distal gastrectomy was performed with D2 lymphadenectomy followed by gastrojejunostomy. He developed an anastomotic gastrointestinal fistula during the postoperative period but was successfully medically treated. The patient received adjuvant chemotherapy with Epirubicin, Cisplatin and 5-Fluorouracil. The patient is still alive, 3 years after the gastrectomy. Conclusion: When faced with a perforated gastric ulcer, one must also consider a neoplastic cause. The emergency surgical treatment depends on the general condition of the patient and the pre-existing co-morbidities, the choice being made between a one-stage versus two-stage gastrectomy.
- Subjects :
- medicine.medical_specialty
business.industry
medicine.medical_treatment
Perforation (oil well)
General Engineering
Energy Engineering and Power Technology
Cancer
Emergency department
Anastomosis
medicine.disease
digestive system diseases
Surgery
03 medical and health sciences
0302 clinical medicine
030220 oncology & carcinogenesis
Perforated ulcer
medicine
030211 gastroenterology & hepatology
Gastrectomy
Surgical emergency
business
Epirubicin
medicine.drug
Subjects
Details
- ISSN :
- 21579415 and 21579407
- Volume :
- 11
- Database :
- OpenAIRE
- Journal :
- Surgical Science
- Accession number :
- edsair.doi...........ca420708b094907120b5d3df8b3183ea
- Full Text :
- https://doi.org/10.4236/ss.2020.1112042