• It is an adenocarcinoma of stomach wall.

• In India the incidence varies from 2 to 6 per 1 lakh population .

• It affected mostly older people
• Diagnosed at 69 years
• It begins with non specific mucosal injury because of infection- H
Pylori.
• Auto immune related infections
• Anti inflammatory agents
• Tobacco use
• It also associated with diets containing smoked foods salted fish and
meat. Pickled vegetables.
• Whole grains and fresh fruits and vegetables associated with reduced
rates of stomach cancer.
• Other associated factors includes;

• Atrophic gastritis, pernicious anemia, adenomatous polyp,

hyperplastic polyps, achlorhydria ( absence off HCL in gastric sytem)

• Smoking and obesity

• First degree relatives of patients with stomach cancer are high risk
• Indigestion
• Abdominal discomfort
• Abdominal pain
• Signs and symptoms of anemia
• Sense of feeling fullness on stomach
• Person appears pale and weak complaining of fatigue ,weakness,
dizziness and shortness of breath.
• Stool ay be positive for occult blood
• Supraclavicular lymph nodes are hard and enlarged
Diagnostic tests
• History and physical examination
• Endoscopy and biopsy
• CT and PET scans
• Upper GI Barium study
• Exfoliative cytologic study
• Endoscopic ultrasonography
• CBC
• Urinalysis
• Stool examination
• Liver enzymes
• Serum amylase
• Tumor markers
Management
• Surgical therapy
• Subtotal gastrectomy( Billroth 1 AND II
procedure
• Total gastrectomy with esophagojejunostomy
• Radiation therapy
• Chemotherapy
• Targeted therapy
Gastric surgery-Post operative
complications
•Dumping syndrome
•Postprandial hypoglycemia
•Bile reflux gastritis