The Postoperative Control of Gastric Carcinoma in a Patient with Spinal Cord Injury

Ken Takahashi, Yoshiharu Nakamura, Eiji Uchida, Moto Kashiwabara, Yonho Lee, Masao Miyashita, Takashi Tajiri and Gengo Kasai*

Surgery of Organ Function and Biological Regulation, Nippon Medical School, Graduate School of Medicine
Department of Internal Medicine, Hasaki Saisei Hospital*

With medical advances, survival of patients with spinal cord injury has gradually lengthened. As a result, they increasingly encounter problems associated with including malignant tumors. We report a rare occurrence of gastric carcinoma in a patient with spinal cord injury. A 60-year-old man who had sustained spinal cord injury in 1971 presented with epigastric pain and tarry stool in June 2002. Fiberscoptic gastroscopy yielded a biopsy specimen from the anterior wall of the body of the stomach that revealed adenocarcinoma. Following total gastrectomy, volume of drainage from a nasogastric tube gradually increased to 825 ml/day, despite bowel movements resuming on the third post operative day. Thease findings indicated dissociation of upper and lower gastrointestinal peristalsis. We prolonged drainage with the nasogastric tube and administered bowel helminth accelerator as appropriate. A fluid diet could be initiated on the 9th postoperative day, and the patient was discharged on the 40th postoperative day. A favorable course following surgery in patients with spinal cord injury requires understanding of the pathophysiology of spinal cord injury as well as careful postoperative observation.

Key words
spinal cord injury, gastric carcinoma

Reprint requests
Ken Takahashi Surgery for Organ Function and Biological Regulation, Nippon Medical School, Graduate School of Medicine
1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603 JAPAN

Accepted
June 30, 2004

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