Gonçalves Roberto, Saad Roberto, Malheiros Carlos Alberto, Kassab Paulo, Vieira Nathália Lins Pontes
MD, MSc. Department of Surgery, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo, SP, Brazil.
MD, PhD. Department of Surgery, FCMSCSP, São Paulo, SP, Brazil.
Rev Assoc Med Bras (1992). 2017 Jun;63(6):484-487. doi: 10.1590/1806-9282.63.06.484.
Perforated gastric carcinoma is a rare condition that is hard to diagnose preoperatively. It is associated with advanced cancer stages and has a high mortality, particularly in cases presenting preoperative shock. Few studies have investigated the presentation and adequate management of these carcinomas. In addition, there are no reports in the literature on perforations extending to the spleen, as described in this case, making the management of these lesions challenging. Our article reports a case of gastric tumor perforation extending to the spleen, which presented as a perforated acute abdomen. The patient was treated with total gastrectomy and D2 lymph node resection with splenectomy and progressed well with current survival of one year at disease stage IV.
胃穿孔性癌是一种罕见疾病，术前难以诊断。它与癌症晚期相关，死亡率高，尤其是术前出现休克的病例。很少有研究探讨这些癌症的表现及适当治疗方法。此外，文献中尚无如本病例所述的穿孔延伸至脾脏的报道，这使得这些病变的治疗具有挑战性。我们的文章报告了一例胃肿瘤穿孔延伸至脾脏的病例，该病例表现为急性穿孔性腹膜炎。患者接受了全胃切除术、D2淋巴结清扫术及脾切除术，病情进展良好，在IV期疾病状态下目前已存活一年。
