Diagnosis and complications of gastric carcinoma

1. DIAGNOSIS OF GASTRIC
CARCINOMA

2. • MEDICAL HISTORY AND PHYSICAL EXAM
• UPPER ENDOSCOPY
Endoscope passed down throat to stomach and checked for any signs of
cancer. If suspicious a piece can be collected(biopsy). In endoscope stomach
cancer looks like an ulcer , a mushroom shaped or protruding mass, or diffuse ,
flat, thickened areas of mucosa known as linitis plastia.
sometimes in cases of heriditary diffuse stomach cancers cannot be seen
during endoscopy.
• ENDOSCOPIC ULTRASOUND
In this a small transducer is placed on the tip of an endoscope. The doctor can
see the layers of stomach wall, as well as the nearby lymph nodes and other
structures just outside the stomach. The picture quality is better than a
standard ultrasound because of shorter distance of the sound waves to travel.
• BIOPSY

3. • Biopsies are obtained mainly through endoscopy and are sent to labs to be
seen under the microscope. The sample contain cancer , and if they do,
what kind it is ( for example , adenocarcinoma, carcinoid gastrointestinal
stromal tumor). If a sample contains adenocarcinoma cells, it may be
tested to see if it has too much of a growth promoting protein called
HER2/neu. If they are HER2 positive can be treated with drugs that target
the HER2/neu protein , such as trastuzumab.
• IMAGING TESTS
1. UPPER GASTROINTESTINAL SERIES
For this test, the patient drinks white chalky solution containing barium . The
barium coats the lining of the oesophagus ,stomach, and the small intestine.
Several x rays are taken and since x rays cant pass through the coating of barium ,
this will outline any abnormalities.
2.COMPUTED TOMOGRAPHY
CT scans can show the stomach clearly and can often confirm the location of
cancer. It also shows the organs in the vicinity of stomach like liver , lymph nodes
and distant organs where cancer might have spread. It helps to determine the
extent of cancer and whether surgery may be a good treatment option.

4. 3. MAGNETIC RESONANCE IMAGING
Used for more information, but used less often.
4. POSITION EMISSION TOMOGRAPHY
In this , a radioactive substance is injected into vein. Because cancer cells grow
faster than normal cells , they take up the radioactive substance. PET is useful if
the doctor thinks that the cancer has spread but dosent know where.
5. CHEST X RAY
It can be used to chack if cancer has spread to the lungs.
• OTHER TESTS
LAPROSCOPY
It is done if stomach cancer has already been found out. Used to detect even
small tumors . Doctors do this beore any other surgery or chemotherapy or
radiation to confirm a stomach cancer is still only in the stomach and can be
removed completely with surgery.

5. • LAB TESTS
CBC for anemia
fecal occult blood test to look for stool in blood

6. COMPLICATIONS

7. • Complications of gastric carinoma include
malnutrition
malabsorption
bowel obstruction
gastrointestinal bleeding’
chemotherapy side effects
-anorexia
-bone marrow damage
-constipation and diarrhoea
-hair loss
-increased risk of infection
-mouth sores
-nausea and vomiting
-weakness or fatigue

8. • POST OPERATION COMPLICATIONS OF GASTRECTOMY
wound infection
leaking from where the stomach has been closed or reattached.
stricture
chest infection
internal bleeding
blockage of the small intestines
acid reflux
vitamin deficiency particularly vit B12, C, and D, obtained from the food you eat.
anemia due to deficiency of vit B12
brittle bones and weakened muscles due to vit D infection.
weight loss , eating even a small meal makes them uncomfortably full.