Gastric Carcinoma

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Gastric Carcinoma

  1. 1. GASTRIC CARCINOMA. UNIVERSIDAD DE GUADALAJARACENTRO UNIVERSITARIO DE CIENCIAS DE LA SALUD Surgical Clinics. Dr. Benjamín Robles Mariscal Profesor Dr. Hector Virgen Ayala Luis Gerardo Caballero Romero. EPG MCPA
  2. 2. • Helicobacter pylori 3.6 a 18 fold risk of developing carcinoma. Proportional Risk serum antibodies to the bacteria.
  3. 3. GASTRIC CARCINOMA• Ulcerative Carcinoma 25%• Polypoid carcinomas 25%• Surface diffusion Carcinoma 15%• Plastic linitis 10%• Advanced Carcinoma 35%
  4. 4. Ulcerative Carcinoma Advanced Carcinoma Polypoid carcinomas Plastic linits
  5. 5. CLINICAL MANIFESTATIONS• Postprandial heaviness. (pain)• Anorexia• Weight loss up to 6 kgs• Vomiting in coffee grounds.
  6. 6. PHYSICAL EXAMINATION• Epigastric mass 25%• Hepatomegaly 10%• FOBT 50%• Abnormal manifestations of tumor dissemination. (Virchow node).• Blumer shelf sign (rectal exam)
  7. 7. DISEMINATIONS• Ovaries (Krukenberg tumor) liver lung brain bones
  8. 8. LABORATORY AND IMAGING STUDIES.• 40% have anemia.• 65% High concentrations of CEA.• Gastroscopy• Gastric biopsy - minimum 6
  9. 9. TREATMENT• Surgical resection (only treatment). 85% of operable patients. 50% lesions can be removed.• Gastrectomy and splenectomy• Esophagogastrectomy.• Palliative therapy.• An adjunct chemotherapy.
  10. 10. FORECAST• Five year survival rate depending on the degree. 70% Stage I 30% Stage II 10% Stage III 0% Stage IV
  11. 11. GASTRIC POLYPS
  12. 12. HISTOLOGICAL CLASSIFICATION• Hyperplastic 80%• Adenomatous 30%• Inflammatory Total gastrectomy in multiple polyposis cases.
  13. 13. GASTRIC LYMPHOMA AND PSEUDOLYMPHOMA• The 2nd most common cancer of the stomach.• non-Hodgkin• MALT• Low and high grade.
  14. 14. SYMPTOMS• Epigastric pain and weight loss• Palpable epigastric mass 50%
  15. 15. TREATMENT• Low-grade lymphoma chemotherapy with cyclophosphamide• high Grade Surgical Resection with total abdominal radiation.
  16. 16. MENETRIER DISEASE• Hypertrophic gastritis.• TGF - α• Evolution to atrophic gastritis
  17. 17. MANIFESTATIONS• Edema• Diarrhea• Anorexia• Weight Loss• exanthema
  18. 18. TREATMENT• Lost control of protein• Eradicating H. pylori• H2 blockers• omeprazole• In children is benign and only refers
  19. 19. PROLAPSE OF THE GASTRIC MUCOSA• Rare lesion.• Prepyloric ulcers accompanied• Vomiting• pain.
  20. 20. TREATMENT• reserved• Billroth I anastomosis Antrecotmia
  21. 21. GASTRIC VOLVULUS
  22. 22. ACUTE• severe pain• Borchardt triad
  23. 23. TREATMENT
  24. 24. BEZOARS• Concretions within the stomach.• Trichobezoars• Phytobezoars• Candida albicans• Postsurgical state by reduction of acid and pepsin secretion
  25. 25. TREATMENT• Defragmentation and dispersal by endoscopy .
  26. 26. THANKS!!!

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