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Scirrhus of the Stomach, a Case Report T. Ujiie 1 , J. Ibayashi 2 1Ujiie Gastrointestinal Clinic Sapporo 2National Hospital of Sapporo and Hokkaido Cancer Center, Gastroenterology Section pp.483-486
Published Date 1974/4/25
DOI https://doi.org/10.11477/mf.1403111797
  • Abstract
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 A periodic health checkup of a man 48 years old on Sept. 1, 1970, revealed atrophic gastritis in both direct radiography and endoscopy. One and half a month later he underwent gastric mass screening with indirect roentgenography (6 exposures). The diagnosis was again atrophic gastritis and no advice was given him for further examination. In January 1971 he had a bout of severe abdominal pain followed by lasting loss of appetite. On April 1 his disorder was diagnosed as gastric scirrhus. On April 22 he was admitted to Sapporo National Hospital, where he died one month later from liver tumor and ascites. Diagnosis at necropsy was diffuse carcinoma of the stomach (centering on the anterior wall side of the lesser curvature of the body). Histologic diagnosis was adenocacinoma tubulare scirrhosum.

 The patient thus died 8 months and a half after the initial health checkup or 7 months after the mass screening. Even retrospectively investigated, no abnormality was to be seen in the roentgenograms (upright barium-filled, prone, double contrast and compression views) exposed at the first examination. Endoscopic pictures with GTF revealed on scrutiny mucosal convergency on the anterior wall side of the lesser curvature in the lower body. The adjacent rugae on the anterior wall were edematous and reddened. The mucosa on the posterior wall at the level of the angle was likewise swollen, discolored and losing tension. This finding might presumably be an endoscopic finding of scirrhus before becoming manifest in roentgenogram.

 It is highly regrettable that, despite extensive mural rigidity to be seen at the time of mass screening in upright and prone barium-filled pictures on the lesser curvature of the lower body, no pertinent advice was given him for detailed examination of the stomach.

 After all, early diagnosis of gastric scirrhus seemingly depends on the detection of small depressed lesions as a forerunner of Borrmann type Ⅳ of gastric carcinoma.


Copyright © 1974, Igaku-Shoin Ltd. All rights reserved.

基本情報

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

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