A Case of Multiple Gastric Carcinoma Developed 56 Years after Gastrojejunostomy for gastric ulcer

Koji Kohno, Takayoshi Sekikawa, Tadahiko Ogawara, Yuji Honda, Shikofumi Tei, Osamu Mitsuki, Yoshiro Matsumoto

First Department of Surgery, Yamanashi Medical College

We report a case of multiple early gastric carcinomas occurring 56 years after gastrojejunostomy. The patient, a 75-year-old man, had received gastrojejunostomy for a gastric ulcer at age of 19 years. Endoscopic examination of the upper gastrointestinal tract showed three kinds of depressed lesions surrounding the stoma. A biopsied specimen revealed moderately differentiated tubular adenocarcinoma. Subtotal gastrectomy including the anastomosis was carried out. Histological examination of the resected specimen revealed five lesions of early gastric carcinoma (type IIc and IIb) limited to the mucosal layer. All of the lesions showed moderately differentiated tubular adenocarcinoma (H₀, P₀, n₀, m, stage I). Gastric carcinoma after gastrojejunostomy is rare, and only 23 cases had been reported in the Japanese literature. With regard to pathogenesis of gastric carcinoma after gastrojejunostomy, reflux of bile and duodenal juice to the stomach is the most important factor.

Key words
multiple gastric carcinoma after gastrojejunostomy, duodenogastric reflux

Reprint requests
Koji Kohno The First Department of Surgery, Yamanashi Medical College
1110 Shimokato, Tamaho-cho, Nakakoma-gun, Yamanashi, 409-38 JAPAN

Accepted
September 9, 1992

To read the PDF file you will need Abobe Reader installed on your computer.