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酷似腹壁脓肿的进展期胃癌穿孔

Advanced Gastric Cancer Perforation Mimicking Abdominal Wall Abscess.

作者信息

Cho Jinbeom, Park Ilyoung, Lee Dosang, Sung Kiyoung, Baek Jongmin, Lee Junhyun

机构信息

Department of Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea.

出版信息

J Gastric Cancer. 2015 Sep;15(3):214-7. doi: 10.5230/jgc.2015.15.3.214. Epub 2015 Sep 30.

Abstract

Surgeons occasionally encounter a patient with a gastric cancer invading an adjacent organ, such as the pancreas, liver, or transverse colon. Although there is no established guideline for treatment of invasive gastric cancer, combined resection with radical gastrectomy is conventionally performed for curative purposes. We recently treated a patient with a large gastric cancer invading the abdominal wall, which was initially diagnosed as a simple abdominal wall abscess. Computed tomography showed that an abscess had formed adjacent to the greater curvature of the stomach. During surgery, we made an incision on the abdominal wall to drain the abscess, and performed curative total gastrectomy with partial excision of the involved abdominal wall. The patient received intensive treatment and wound management postoperatively with no surgery-related adverse events. However, the patient could not receive adjuvant chemotherapy and expired on the 82nd postoperative day.

摘要

外科医生偶尔会遇到患有侵犯相邻器官(如胰腺、肝脏或横结肠)的胃癌患者。尽管对于侵袭性胃癌的治疗尚无既定指南,但传统上为了治愈目的会进行联合根治性胃切除术。我们最近治疗了一名患有侵犯腹壁的巨大胃癌患者,该患者最初被诊断为单纯腹壁脓肿。计算机断层扫描显示在胃大弯附近形成了一个脓肿。手术过程中,我们在腹壁做了切口以引流脓肿,并进行了根治性全胃切除术及受累腹壁部分切除术。患者术后接受了强化治疗和伤口处理,未出现与手术相关的不良事件。然而,患者无法接受辅助化疗,术后第82天死亡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d83e/4604337/c6b70fc2b11b/jgc-15-214-g001.jpg

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