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On Perforated Cases of Gastric Cancer M. Nishi 1 , T. Kanno 1 , F. Kasumi 1 , G. Sakamoto 2 , M. Sato 3 1Dept. of Surgery, Cancer Institute Hospital 2Dept. of Pathology, Cancer Institute Hospital 3Omiya Soai Hospital pp.437-443
Published Date 1971/4/25
DOI https://doi.org/10.11477/mf.1403111558
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 Of 4,576 cases of gastric cancer surgically treated up to the end of January 1970 at the Surgical Department, Cancer Institute Hospital, perforated cases of gastric cancer numbered only 7, or 0.15 per cent. Clinical and pathological review has been tried on these cases together with 5 cases treated in other hospitals.

 Gastric perforation was seen far frequently in the male; 10 cases were male and only 2 were female.

 Prior to about one week before surgical exploration, the patients used to complain of aggravated pain, vomiting and hematemesis, and many of them had undergone various examinations on these accounts. Surgically the stomach was removed in 7 cases, and closure of perforation in 5. Mostly the patients were in such a weakened state due to advanced carcinoma that prognosis after resection proved very unsatisfactory.

 The gastric cancer which caused acute perforation belonged to localized, differentiated medullary adenocarcinoma, showing more rapid degree of infiltration and spread. A cancer nest that tends to be accompanied with necrosis and infection may proliferate in such a manner as to displace or penetrate the muscularis propriae. Such a lesion easily leads to perforation of the gastric wall.

 Classified according to Borrmann, perforative cancer mostly belongs to Type Ⅲ. S-, N-, P-, H-factor is also high.

 Perforation is caused either by penetration of cancer lesion itself or by that of thin ulcer floor consisting of connective tissues that are free from cancer cells. In either case, no scarification has taken place in the surrounding areas, and the whole picture shows findings of acute ulcer.


Copyright © 1971, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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