Gastric Carcinoma Associated With Gastroenterostomy

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CARCINOMA of the stomach is an uncommon complication in patients who have undergone gastroenterostomy. Gray and Lofgren1 found only 17 cases of carcinoma in 825 instances where surgical exploration of a previously performed gastroenterostomy was undertaken. The infrequency of coexistent duodenal ulcer and gastric carcinoma has been repeatedly emphasized (Bockus,2 Eusterman and Balfour,3 Fischer et al4). Orringer,5 in a recent review of the literature, was able to accumulate only 32 instances of gastric malignancy which developed following surgery for chronic duodenal ulcer.

Gastroenterostomy has been performed in the past as a definitive operation for benign or supposedly benign gastric lesions. One might expect that instances of gastric carcinoma associated with gastroenterostomy would be found in this group. Some of the gastric ulcers thought to be benign at the time of operation might have been, in reality, neoplastic. Furthermore, some authorities believe that a malignant change can occur in a benign gastric ulcer. It is surprising, therefore, to find little in the literature regarding such cases. Gray and Lofgren1 in their large series, reported only 6 patients with carcinoma of the stomach in whom gastroenterostomy had previously been performed for presumably benign gastric ulcers.

We have recently studied 3 patients in whom cancer of the stomach and gastroenterostomy were found to be associated. We are reporting these cases because of their relative rarity and because they illustrate several interesting points in diagnosis.

Case 1. A 60 year old white male cook was admitted to the Cleveland Clinic November 5, 1951, complaining. . .



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