subjective: 63 y/o, female epigastric pain vomiting weight loss early satiety easy fatigability...
TRANSCRIPT
![Page 1: SUBJECTIVE: 63 y/o, female Epigastric pain Vomiting Weight loss Early satiety Easy fatigability OBJECTIVE: CT scan: gastric mucosal thickening (+)pallor](https://reader031.vdocuments.mx/reader031/viewer/2022020319/56649f1b5503460f94c306ac/html5/thumbnails/1.jpg)
SUBJECTIVE:• 63 y/o, female• Epigastric pain• Vomiting• Weight loss• Early satiety• Easy fatigability
OBJECTIVE:• CT scan: gastric mucosal
thickening• (+)pallor• Pale palpebral conjunctiva• (+) bulging flanks• (+) epigastric tenderness• (+) shifting dullness• (+) fluid wave• (-) succusion splash• (+) soft 1x1 cm mass, above
the pectinate line, 12 o’ clock position, non-tender
SALIENT FEATURES
![Page 2: SUBJECTIVE: 63 y/o, female Epigastric pain Vomiting Weight loss Early satiety Easy fatigability OBJECTIVE: CT scan: gastric mucosal thickening (+)pallor](https://reader031.vdocuments.mx/reader031/viewer/2022020319/56649f1b5503460f94c306ac/html5/thumbnails/2.jpg)
• Abdominal pain• Weight loss and satiety• Previous biopsy and
endoscopy findings
• Abdominal pain• Weight loss and satiety• Worsening of symptoms
despite CaCO3• Ascites and abdominal mass• CT scan
Benign or Malignant?
![Page 3: SUBJECTIVE: 63 y/o, female Epigastric pain Vomiting Weight loss Early satiety Easy fatigability OBJECTIVE: CT scan: gastric mucosal thickening (+)pallor](https://reader031.vdocuments.mx/reader031/viewer/2022020319/56649f1b5503460f94c306ac/html5/thumbnails/3.jpg)
CT SCAN: 11/21/09
![Page 4: SUBJECTIVE: 63 y/o, female Epigastric pain Vomiting Weight loss Early satiety Easy fatigability OBJECTIVE: CT scan: gastric mucosal thickening (+)pallor](https://reader031.vdocuments.mx/reader031/viewer/2022020319/56649f1b5503460f94c306ac/html5/thumbnails/4.jpg)
CT SCAN: 11/21/09
![Page 5: SUBJECTIVE: 63 y/o, female Epigastric pain Vomiting Weight loss Early satiety Easy fatigability OBJECTIVE: CT scan: gastric mucosal thickening (+)pallor](https://reader031.vdocuments.mx/reader031/viewer/2022020319/56649f1b5503460f94c306ac/html5/thumbnails/5.jpg)
CT SCAN: 11/21/09
![Page 6: SUBJECTIVE: 63 y/o, female Epigastric pain Vomiting Weight loss Early satiety Easy fatigability OBJECTIVE: CT scan: gastric mucosal thickening (+)pallor](https://reader031.vdocuments.mx/reader031/viewer/2022020319/56649f1b5503460f94c306ac/html5/thumbnails/6.jpg)
CT with contrast of the abdomen
![Page 7: SUBJECTIVE: 63 y/o, female Epigastric pain Vomiting Weight loss Early satiety Easy fatigability OBJECTIVE: CT scan: gastric mucosal thickening (+)pallor](https://reader031.vdocuments.mx/reader031/viewer/2022020319/56649f1b5503460f94c306ac/html5/thumbnails/7.jpg)
Normal CT with contrast of the abdomen Patient’s CT with contrast (Nov 2009)
![Page 8: SUBJECTIVE: 63 y/o, female Epigastric pain Vomiting Weight loss Early satiety Easy fatigability OBJECTIVE: CT scan: gastric mucosal thickening (+)pallor](https://reader031.vdocuments.mx/reader031/viewer/2022020319/56649f1b5503460f94c306ac/html5/thumbnails/8.jpg)
Discussion
![Page 9: SUBJECTIVE: 63 y/o, female Epigastric pain Vomiting Weight loss Early satiety Easy fatigability OBJECTIVE: CT scan: gastric mucosal thickening (+)pallor](https://reader031.vdocuments.mx/reader031/viewer/2022020319/56649f1b5503460f94c306ac/html5/thumbnails/9.jpg)
CT with contrast of the abdomen
![Page 10: SUBJECTIVE: 63 y/o, female Epigastric pain Vomiting Weight loss Early satiety Easy fatigability OBJECTIVE: CT scan: gastric mucosal thickening (+)pallor](https://reader031.vdocuments.mx/reader031/viewer/2022020319/56649f1b5503460f94c306ac/html5/thumbnails/10.jpg)
Normal CT with contrast of the abdomen Patient’s CT with contrast (Nov 2009)
![Page 11: SUBJECTIVE: 63 y/o, female Epigastric pain Vomiting Weight loss Early satiety Easy fatigability OBJECTIVE: CT scan: gastric mucosal thickening (+)pallor](https://reader031.vdocuments.mx/reader031/viewer/2022020319/56649f1b5503460f94c306ac/html5/thumbnails/11.jpg)
![Page 12: SUBJECTIVE: 63 y/o, female Epigastric pain Vomiting Weight loss Early satiety Easy fatigability OBJECTIVE: CT scan: gastric mucosal thickening (+)pallor](https://reader031.vdocuments.mx/reader031/viewer/2022020319/56649f1b5503460f94c306ac/html5/thumbnails/12.jpg)
![Page 13: SUBJECTIVE: 63 y/o, female Epigastric pain Vomiting Weight loss Early satiety Easy fatigability OBJECTIVE: CT scan: gastric mucosal thickening (+)pallor](https://reader031.vdocuments.mx/reader031/viewer/2022020319/56649f1b5503460f94c306ac/html5/thumbnails/13.jpg)
Metastatic breast
cancer to the
stomach with a
linitis plastica
appearance on
CT. MDCT image
in an elderly
woman with
metastatic breast
carcinoma and
early satiety
shows marked
thickening of the
wall of the gastric
antrum (arrows).
The radiographic
findings are
indistinguishable
from those of a
primary scirrhous
carcinoma of the
stomach.
![Page 14: SUBJECTIVE: 63 y/o, female Epigastric pain Vomiting Weight loss Early satiety Easy fatigability OBJECTIVE: CT scan: gastric mucosal thickening (+)pallor](https://reader031.vdocuments.mx/reader031/viewer/2022020319/56649f1b5503460f94c306ac/html5/thumbnails/14.jpg)
Axial contrast-enhanced CT scan shows diffuse thickening of the stomach in this patient with gastric lymphoma.
![Page 15: SUBJECTIVE: 63 y/o, female Epigastric pain Vomiting Weight loss Early satiety Easy fatigability OBJECTIVE: CT scan: gastric mucosal thickening (+)pallor](https://reader031.vdocuments.mx/reader031/viewer/2022020319/56649f1b5503460f94c306ac/html5/thumbnails/15.jpg)
Mucinous
adenocarcinoma of the
stomach. CT image
shows massive thickening
of the gastric wall and
marked luminal narrowing
by an advanced, infiltrating
carcinoma. Also note
extensive calcification
within the tumor. This type
of calcification is
characteristic of mucinous
adenocarcinomas of the
stomach.
![Page 16: SUBJECTIVE: 63 y/o, female Epigastric pain Vomiting Weight loss Early satiety Easy fatigability OBJECTIVE: CT scan: gastric mucosal thickening (+)pallor](https://reader031.vdocuments.mx/reader031/viewer/2022020319/56649f1b5503460f94c306ac/html5/thumbnails/16.jpg)
CT demonstrates subtle nodularity and stranding of the mesentery and more apparent nodularity along the greater omentum (arrows) in a patient with ovarian cancer. A small amount of ascites (A) also can be seen.