Division of Healthy Ageing, Alexandra Hospital, National University Health System, 378 Alexandra Road, Singapore, 159964, Singapore.
Department of Pathology, National University Hospital, National University Health System, Singapore, Singapore.
BMC Gastroenterol. 2021 Oct 18;21(1):381. doi: 10.1186/s12876-021-01964-6.
Gastric tumors become increasingly prevalent with advanced age but can be challenging to diagnose in older adults who may present with non-specific symptoms. Here, we report a rare case of an occult gastric tumor associated with mesenteric panniculitis that presented with recurrent falls precipitated by vertigo.
We describe a diagnostically challenging case of cryptogenic gastric tumor associated with mesenteric panniculitis in a 74-year-old female who presented with abdominal bloating and recurrent falls precipitated by vertigo, dehydration, acute kidney injury and electrolyte deficiencies, but had no alarm symptoms. Her symptoms resolved after laparoscopic wedge resection of the gastric tumor.
Our case highlights that while alarm symptoms such as dysphagia, weight loss, gastrointestinal bleeding and vomiting are considered indications for endoscopy, clinicians should also maintain a high index of suspicion for gastric tumors in older patients who may present with atypical symptoms.
随着年龄的增长，胃肿瘤变得越来越普遍，但对于可能出现非特异性症状的老年人来说，诊断胃肿瘤具有一定挑战性。在此，我们报告一例罕见的隐匿性胃肿瘤伴肠系膜脂膜炎病例，其表现为因眩晕导致反复跌倒。
我们描述了一例 74 岁女性的隐匿性胃肿瘤伴肠系膜脂膜炎的诊断难题病例，该患者因腹部肿胀和眩晕导致反复跌倒，伴有脱水、急性肾损伤和电解质缺乏，但无报警症状。她的症状在腹腔镜楔形胃肿瘤切除术后得到缓解。
我们的病例强调，虽然吞咽困难、体重减轻、胃肠道出血和呕吐等报警症状被认为是内镜检查的指征，但临床医生也应保持高度警惕，对于可能出现非典型症状的老年患者，也应考虑胃肿瘤的可能性。
