STOMACH

TUMOURS OF THE STOMACH

Ep.
More common in man than in women
More frequent in China, Japan, Chile, former
USSR, Est Europe; low in India, Africa
USA annual incidence 10:100.000 (1/10 than in
Japan, 1/5 in former USSR
Dramatic decline in incidence in past 20-30
years
 TUMOURS OF THE STOMACH

Etiology and Pathohenesis

Risc factors:
diet: high carbohidrates and salt preserved
foods, deficiet in fruits and vegetable
high dietary intake of nitrates (preservation
food)
Helicobacter pylori
atrophic gastritis (pernitious anemia)
partial gastrectomy (more than 15 years)
Malignant gastric neoplasms
 Clinical Features
Asimptomatic until advance stage
Simptoms
Non-specific: epigastric pain, early satiety,
bloating, nausea, vomiting,
Gastrointestinal hemorrhage, gastric outlet
obstruction
Phisical examination
general inspection: wight loss, pale
palpation: pain in epigastrium, tumor,
adenopaty, hepatomegaly
 INVESTIGATIONS
Laboratory:
anemia -iron deficiency
hypoalbuminemia- poor nutrition
abnormal liver chemistry - hepatic involvement
GASTROINTESTINAL ENDOSCOPY
RADIOGRAPHIC STUDIES
STAGING
conputer tomography
ultrasonography
echoendoscopy
Gastric carcinoma
Endoscopic view reveals presence of obviously ulcerated mass
Endoscopic ultrasound confirms the depth of invasion
Carcinoma in the body of the stomach