Metastatic Gastric Cancer Presenting as Incarcerated Ventral Hernia: Report of a Case

轉移性胃癌以嵌閉性腹壁疝氣表現：病例報告

洪宗義(Tsung-I Hung) ； 朱光恩(Kuang-En Chu)

《Formosan Journal of Surgery》 39卷4期 (2006/08) Pp. 196-199

https://doi.org/10.29833/FJS.200608.0005

摘要

胃癌是台灣地區癌症第五大死因，而腹壁疝氣是腹腔手術常見的合併症，此二者都是臨床上常見的疾病情況，但在文獻上並未報告此二種疾病在臨床上合併表現的情況。我們報告一罕見合併此二種疾病的臨床病例及探討臨床上較合適的處置方向。臨床上偶而會遇到病患就醫即呈現廣泛性腹腔內癌性轉移的情形，因原始腫瘤的症狀不明顯，臨床上會有診斷及治療方面的困擾，原始腫瘤未明的廣泛性腹腔內癌性轉移案例中，雖以胃癌及大腸癌的案例最多，但胰臟癌及婦科方面的案例亦不少，為了診斷及組織切片的取得常需要一些侵襲性的檢查如胃鏡或大腸鏡等，增加病患的痛苦。當此類病患合併有腹壁疝氣及疝氣內有腫瘤細胞嵌閉時，腹壁疝氣提供一簡單提供組織診斷的地方，同時亦可解決病患嵌閉疝氣的不舒服，根據病理報告選擇檢查的方向，減少不必要的侵襲性檢查，甚至可避免不必要的剖腹探查。

並列摘要

Ventral hernia and gastric cancer are both common clinical entities, but their coexistence is extremely rare. In particular, the occurrence of gastric cancer with tumor implant inside a ventral hernia has not been reported. We describe a case of gastric cancer presenting as an incarcerated ventral hernia and discuss methods of treatment. Cases presenting as peritoneal carcinomatosis with unknown origin are always a challenge for the physicians to select the most appropriate method to make the diagnosis. In this particular case, the pathological report obtained directly from the incarcerated tumor implant showed the tumor to have arisen most probably from the stomach. We decided to avoid unnecessary examinations except panendoscopy before achieving the diagnosis. In this way, we relieved the patient s symptoms and discomfort immediately without further unnecessary invasive procedures such as a colonoscopy.

並列關鍵字

gastric cancer ； incarcerated ventral hernia