J Gastric Cancer.  2015 Sep;15(3):214-217. 10.5230/jgc.2015.15.3.214.

Advanced Gastric Cancer Perforation Mimicking Abdominal Wall Abscess

• Cho J
• Park I
• Lee D
• Sung K
• Baek J
• Lee J

• KMID: 2372208
• DOI: http://doi.org/10.5230/jgc.2015.15.3.214

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.

Keyword

Gastric cancer; Neoplasm invasion; Stomach rupture

MeSH Terms

Abdominal Wall*
Abscess*
Chemotherapy, Adjuvant
Colon, Transverse
Gastrectomy
Humans
Liver
Neoplasm Invasiveness
Pancreas
Stomach
Stomach Neoplasms*
Stomach Rupture
Surgeons
Wounds and Injuries

Figure

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  Fig. 1 The initial presentation of the patient's abdomen.

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  Fig. 2 Computed tomography of the abdomen reveals suspected gastric perforation.

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  Fig. 3 Operative findings reveal gastric cancer perforation and invasion through the entire abdominal wall.

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  Fig. 4 Photograph of the wound taken immediately after surgery. There is no remaining tissue between the intra-abdominal cavity and overlying skin layer.

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  Fig. 5 Cancer growth into the wound.

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