Presentation
Weight loss and constipation. Iron deficiency anemia. Strong clinician suspicion of GI tract malignancy.
Patient Data
The stomach is diffusely thick walled and incompletely distended.
Studding of the anterior peritoneum with small nodules. Small volume ascites.
No solid organ metastases.
EGD performed. Superficial mucosa normal but ridgid stiff stomach. Deep Bx taken.
Endoscopic biopsy identified a gastric adenocarcinoma.
Case Discussion
Linitis plastica is the term atrributed to the specific appearances of the stomach with diffuse adenocarcinoma. The stomach is small, non-distendable with a diffusely thickened wall, the appearance referred to as like a traditional water bottle.
The underlying cause is almost always a scirrhous adenocarcinoma with diffuse submucosal infiltration, which contributes to the thickening and rigidity to the stomach wall observed on CT or endoscopy.
This form of gastric carcinoma is usually advanced on presentation as in this case with peritoneal disease.
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