Acute upper gastrointestinal bleeding as primary symptom of gastric carcinoma

Abstract

Little information is available regarding acute upper gastrointestinal bleeding as a presenting sign of gastric carcinoma. Of 427 patients with gastric cancer, 36 (8.4%) underwent early endoscopy due to hematemesis. The hemorrhage was self-limited in 16 patients (44.4%), most of whom underwent elective surgery. Twenty patients (55.6%) had persistent or massive bleeding, and 13 of these underwent early surgery with a surgical mortality of 3 cases (23.1%); the remaining 7 patients were not operated on, and died secondary to the hemorrhage. The total mortality rose to 10 patients (27.7%). The mean age was higher in patients with persistent or massive bleeding, mainly in those who did not undergo surgery and died. We conclude that the immediate outcome is related to age and previous general condition, rather than to the definite diagnosis of gastric cancer. Moreover, emergency endoscopy may be useful in determining the exact source of hemorrhage and in identifying potential candidates for emergency surgery.

Correlation between Multi-Drug Resistance-Associated Membrane Transport in Clonal Cancer Cells and the Cell Cycle Phase

“…4C frequency polygons). The modal values of MDR activity characterize the most abundant cell type in the population and often determines tumor behaviour [32]. Here, we did not consider the likely presence of a side population with elevated MDR activity ( V max ), which could exert only a minor contribution to the overall distribution of MDR activity within the entire population.…”

Transcatheter arterial embolization in gastric cancer patients with acute bleeding

“…More than 10% of unresectable gastric cancers show evidence of bleeding before or at presentation [1][2][3][4]. The use of endoscopy may lead to gastric cancer becoming a more commonly recognized cause of gastric bleeding [5]. The reported incidence of gastric bleeding associated with gastric cancer ranges from 1 to 8% [5][6][7][8][9][10].…”

“…The use of endoscopy may lead to gastric cancer becoming a more commonly recognized cause of gastric bleeding [5]. The reported incidence of gastric bleeding associated with gastric cancer ranges from 1 to 8% [5][6][7][8][9][10]. As a first line to achieve hemostasis, therapeutic endoscopy has been used for gastric cancer bleeding [11][12][13]; however, endoscopic bleeding control is difficult when bleeding is massive or diffuse [8].…”

Outcomes after emergency surgery for gastric perforation or severe bleeding in patients with gastric cancer

“…Such emergencies are rare in Japanese patients because most Japanese patients have their cancer detected at an of early stage. Perforation has been widely reported to occur in 0.56 to 3.9% of all cases of gastric cancer [1][2][3][4][5], and major bleeding has been reported to occur in as many as 5% of patients [6][7][8]. These emergencies are also rare in the West, and have been described in only a small number of reports in the English literature over the past 20 years [1][2][3][4][5]9].…”