Gastric outlet obstruction - gastric adenocarcinoma

Case contributed by Dr Ian Bickle

Presentation

Iron deficiency anaemia. Endoscopy suspicious for gastric carcinoma. Gastric outlet obstruction?

Patient Data

Age: 50 years
Gender: Female

Long circumferentially thickening segment of antrum and pylorus with a wall thickeness exceeding 1cm. 

The stomach is markedly distended containing food residue.

Perigastric stranding and small volume lymphadenopathy upto 7mm at the site of the thickened gastric wall.

The solid organs are normal.

Gallstones.

Case Discussion

The appearances are typical of a gatsric adenocarcioma involving the distal stomach resulting in gastric outlet obstruction.

Typical modes of presentation are iron deficiency anemia (as in this case), weight loss or vomiting.

The stomach wall is much better appreciated with a distended stomach lumen (ideally water as a negative contrast agent) when assessing it with CT.

ENDOSCOPIC BIOPSY:  Diffuse infiltrating gastric adenocarcinoma

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Case information

rID: 59301
Published: 2nd Apr 2018
Last edited: 14th Aug 2019
Tag: ripas2
Inclusion in quiz mode: Included

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