ATYPICAL PRESENTATION OF GASTRIC CANCER APPROACHED VIA RETROGRADE SINGLE BALLOON ENTEROSCOPY RUNNING TITLE
Atypical presentation of Gastric Carcinoma
AUTHORS
Dr. N***** ********* M.D.
Dr. H**** Y***** MBBS
ABSTRACT
Globally Gastric cancer is the fifth most common cancer. Regular screening and early detection has decreased incidence of stomach cancer has decreased in Western world in the last 10 years. The American Cancer Society’s estimates for stomach cancer in the United States for 2018 are:
• About 26,240 cases of stomach cancer will be diagnosed (16,520 in men and 9,720 in women)
• About 10,800 people will die from this cancer (6,510 men and 4,290 women)[1] (https://www.cancer.org/cancer/stomach-cancer/about/key-statistics.html …show more content…
Diet related risk factors are food rich in salt like cured fish, pickles or smoked food high in nitrates. [5]
Chronic inflammatory state affecting GI tract like atrophic gastritis or any radiation exposure are some examples of environmental factors. Smoking directly correlates with the increase in risk as well.
Chronic Helicobacter pylori induced inflammation is still the strongest risk factor for Gastric cancer. Previous gastric surgery also contributes as a risk factor as it disturbs the normal ph of stomach leading to metaplasia and dysplasia in stomach luminal cells. Genetic factors also contribute to a portion of stomach cancers they include Hereditary non-polyposis colorectal cancer, Peutz-Jeghers syndrome, Familial adenomatous polyposis and Li Fraumeni syndrome.
Stomach is divided into two parts proximal and distal. The proximal part is further divided into Cardia, Fundus and Body and the distal part is divided into Antrum and Pylorus. The antrum is the smaller distal one-third part of the stomach. Pylorus is the narrow channel (1-2cm) that connects the stomach with …show more content…
Thorough physical exam performed and basic lab work done. Early detection and treatment can change the outcome of the disease for this Endoscopic biopsy being highly sensitive and sensitive comes into play. It not only helps in accurate visualization but also tells extent of the tumor, histopathology confirmation, typing and staging.
Length of small bowel is 600 cm or 20 feet long and its tortuous anatomy makes it challenging to examine. Current advanced endoscopic techniques have provided both therapeutic and diagnostic edge in gastrointestinal imaging world.
In 2001, double balloon enteroscopy was introduced which was then upgraded to single balloon enteroscopy (SBE) a few years later. Single balloon enteroscopy was done one our patient. The long flexible endoscope (200 cm or 8 feet) go deep in the small bowel has an over tube with a balloon at the tip. Repeated push and pull of the overtube helps reducing loops of the small bowel thus pleating the small bowel on tube. [7]Abnormal tissue seen on the enteroscope examination was biopsied. Sample sent to the pathologist for histological microscopic exam. Final pathologic diagnosis was Adenocarcinoma in situ.
Atypical presentation of Gastric Carcinoma
AUTHORS
Dr. N***** ********* M.D.
Dr. H**** Y***** MBBS
ABSTRACT
Globally Gastric cancer is the fifth most common cancer. Regular screening and early detection has decreased incidence of stomach cancer has decreased in Western world in the last 10 years. The American Cancer Society’s estimates for stomach cancer in the United States for 2018 are:
• About 26,240 cases of stomach cancer will be diagnosed (16,520 in men and 9,720 in women)
• About 10,800 people will die from this cancer (6,510 men and 4,290 women)[1] (https://www.cancer.org/cancer/stomach-cancer/about/key-statistics.html …show more content…
Diet related risk factors are food rich in salt like cured fish, pickles or smoked food high in nitrates. [5]
Chronic inflammatory state affecting GI tract like atrophic gastritis or any radiation exposure are some examples of environmental factors. Smoking directly correlates with the increase in risk as well.
Chronic Helicobacter pylori induced inflammation is still the strongest risk factor for Gastric cancer. Previous gastric surgery also contributes as a risk factor as it disturbs the normal ph of stomach leading to metaplasia and dysplasia in stomach luminal cells. Genetic factors also contribute to a portion of stomach cancers they include Hereditary non-polyposis colorectal cancer, Peutz-Jeghers syndrome, Familial adenomatous polyposis and Li Fraumeni syndrome.
Stomach is divided into two parts proximal and distal. The proximal part is further divided into Cardia, Fundus and Body and the distal part is divided into Antrum and Pylorus. The antrum is the smaller distal one-third part of the stomach. Pylorus is the narrow channel (1-2cm) that connects the stomach with …show more content…
Thorough physical exam performed and basic lab work done. Early detection and treatment can change the outcome of the disease for this Endoscopic biopsy being highly sensitive and sensitive comes into play. It not only helps in accurate visualization but also tells extent of the tumor, histopathology confirmation, typing and staging.
Length of small bowel is 600 cm or 20 feet long and its tortuous anatomy makes it challenging to examine. Current advanced endoscopic techniques have provided both therapeutic and diagnostic edge in gastrointestinal imaging world.
In 2001, double balloon enteroscopy was introduced which was then upgraded to single balloon enteroscopy (SBE) a few years later. Single balloon enteroscopy was done one our patient. The long flexible endoscope (200 cm or 8 feet) go deep in the small bowel has an over tube with a balloon at the tip. Repeated push and pull of the overtube helps reducing loops of the small bowel thus pleating the small bowel on tube. [7]Abnormal tissue seen on the enteroscope examination was biopsied. Sample sent to the pathologist for histological microscopic exam. Final pathologic diagnosis was Adenocarcinoma in situ.