Gastric Cancer.  El Salvador Atlas of Gastrointestinal VideoEndoscopy. A Large Database of Images and Video Clips with Cases Reported.
El Salvador Atlas of Gastrointestinal VideoEndoscopy

 

Gastric Adenocarcinoma with gastric varices and atrophic gastritis.  A 95 year-old male was hospitalized because of pallor and  melena with 8.0 mg/dl. of Hb.

Video Endoscopic Sequence 1 of 8.

Gastric Adenocarcinoma with gastric varices and atrophic gastritis.

 A 95 year-old male was hospitalized because of pallor and
 melena with 8.0 mg/dl. of Hb.

 For more endoscopic details download the video clips by
 clicking on the endoscopic images, wait to be downloaded
 complete then press Alt and Enter that you can appreciate
 the video in full screen.

 All endoscopic images shown in this Atlas contain
 video clips.

        

Several conditions may be precancerous and may increase the risk of stomach cancer. They include: atrophic gastritis, chronic gastritis (inflammation of the stomach lining), and infection by a certain type of bacteria. pernicious anemia: a chronic vitamin-B12 deficiency anemia that occurs in older adults characterized by numbness and tingling in the extremities.  achlorhydria: low levels or absence of hydrochloric acid in gastric juice.

Video Endoscopic Sequence 2 of 8.

 Several conditions may be precancerous and may increase
 the risk of stomach cancer. They include:

  • Atrophic gastritis, chronic gastritis (inflammation of the stomach lining), and infection by a certain type of bacteria.
  • Pernicious anemia: a chronic vitamin-B12 deficiency anemia that occurs in older adults characterized by numbness and tingling in the extremities.
  • Achlorhydria: low levels or absence of hydrochloric acid in gastric juice.
Another image and video clip of this ulcerated neoplasia.

Video Endoscopic Sequence 3 of 8.

 Another image and video clip of this advanced and ulcerated neoplasia.

This image and the video clip display chromoendoscopy with lugolīs stain. Chromoendoscopy and vital staining are simple adjunct  methods to improve the yield of endoscopic.

Video Endoscopic Sequence 4 of 8.

  This image and the video clip display chromoendoscopy
  with lugolīs stain.

 Chromoendoscopy and vital staining are simple adjunct
 methods to improve the yield of endoscopic.

 

Some isolated gastric varices were found at the fundus.

Video Endoscopic Sequence 5 of 8.

Some isolated gastric varices were found at the fundus.

Islated gastric varices are more common with adenocarcinoma of the pancreas due to splecnic thrombosis.

Video Endoscopic Sequence 6 of 8.

 Islated gastric varices are more common with
 adenocarcinoma of the pancreas due to splecnic thrombosis.

 

More images and video clips of this case of  adenocarcinoma and gastric varices.

Video Endoscopic Sequence 7 of 8.

 More images and video clips of this case of
 adenocarcinoma with gastric varices.

This image display the neoplasia in frontal view.

Video Endoscopic Sequence 8 of 8.

This image display the neoplasia in frontal view.

CaRecidivantesalaz1

Video Endoscopic Sequence 1 of 4.

Recurrent Gastric Adenocarcinoma

This 75 year-old female, 3 months previous, in another country underwent a subtotal gastrectomy due to a gastric adenocarcinoma.

CaRecidivantesalaz2

Video Endoscopic Sequence 2 of 4.

Endoscopy of Recurent Gastric Adenocarcinoma

CaRecidivantesalaz3

Video Endoscopic Sequence 1 of 3.

Endoscopy appearanceGastric Adenocarcinoma

CaRecidivantesalaz4

Video Endoscopic Sequence 4 of 4.

Endoscopy of Recurent Gastric Adenocarcinoma

Gastric Adenocarcinoma with signet ring cells. A 73 year-old female with obstructing ulcerated gastric neoplasia  that made pseudo piloro and infiltrated the posterior wall of the antrum.

Video Endoscopic Sequence 1 of 4.

 Endoscopy of Gastric Adenocarcinoma with signet ring cells

 A 73 year-old female with obstructing ulcerated gastric
 neoplasia that made pseudo piloro and infiltrated the
 posterior wall of the antrum.

 Status post Surgery of the case above displayed  Jejuno-Jejuno anastomosis.  The image and the video display the Jejuno-jejuno  anastomosis.

Video Endoscopic Sequence 2 of 4.

 Status post Surgery of the case above displayed
 Jejuno-Jejuno anastomosis.

 The image and the video display the Jejuno-jejuno
 anastomosis.

Status post Surgery of the case above displayed  Jejunum-jejunum  anastomosis.

Video Endoscopic Sequence 3 of 4.

 Status post Surgery of the case above displayed
 
Jejunum-jejunum anastomosis.

Status post surgery of gastric carcinoma. Four months after the surgery a new endoscopy was performed, the image and the video display the gastro-jejunostomy.

Video Endoscopic Sequence 4 of 4.

 Status post surgery of gastric carcinoma.
 Four months after the surgery a new endoscopy was
 performed, the image and the video display the
 gastro-jejunostomy. 

An 84 year-old male who presented with early satiety and postprandial vomiting, suggestive of gastric outlet  obstruction, along with weight loss and anemia.

Ulcerated Gastric Carcinoma of the Antrum.

 An 84 year-old male who presented with early satiety and
 postprandial vomiting, suggestive of gastric outlet
 obstruction, along with weight loss and anemia.

 

Early Gastric Cancer type I. Polypoid lesion that protrudes into the lumen of the stomach, but does not invade the muscular propia. The lesion was only 3mm in its diameter. (Pathological specimen).

Endoscopy of Early Gastric Cancer type I.

 Polypoid lesion that protrudes into the lumen of the
 stomach, but does not invade the muscular propia.
 The lesion was only 3mm in its diameter. (Pathological
 specimen).

Early Gastric Cancer.  This 60 year-old male with vague abdominal discomfort.

Video Endoscopic Sequence 1 of 21.

Endoscopy of Early Gastric Cancer.

This 60 year-old male with vague abdominal discomfort.

 

Early disease has no associated symptoms; however, some patients with incidental complaints are diagnosed with early gastric cancer. Most symptoms of gastric cancer reflect advanced disease. Patients may complain of indigestion, nausea or vomiting, dysphagia, postprandial fullness, loss of appetite, and weight loss.   ate complications include pathologic peritoneal and pleural effusions; obstruction of the gastric outlet, gastroesophageal junction, or small bowel; bleeding in the stomach from esophageal varices or at the anastomosis after surgery; intrahepatic jaundice caused by hepatomegaly; extrahepatic jaundice; and inanition resulting from starvation or cachexia of tumor origin.

Video Endoscopic Sequence 2 of 21.

  Early disease has no associated symptoms; however, some
 patients with incidental complaints are diagnosed with early
 gastric cancer. Most symptoms of gastric cancer reflect
 advanced disease. Patients may complain of indigestion,
 nausea or vomiting, dysphagia, postprandial fullness, loss
 of appetite, and weight loss.

  • Late complications include pathologic peritoneal and pleural effusions; obstruction of the gastric outlet, gastroesophageal junction, or small bowel; bleeding in the stomach from esophageal varices or at the anastomosis after surgery; intrahepatic jaundice caused by hepatomegaly; extrahepatic jaundice; and inanition resulting from starvation or cachexia of tumor origin.
As proposed by the Japanese Society of Gastroenterological Endoscopy in 1962, early gastric cancer (EGC, also called superficial spreading carcinoma) is defined as adenocarcinoma limited to the gastric mucosa and submucosa regardless of whether regional lymph nodes are involved or not. This definition reflected an appreciation that EGC represented a subset of gastric cancers that had a favorable prognosis. Survival rates of 85 to more than 90 percent five years after resection have been reported in Japan and the West . In one series from Europe, for example, survival was similar for EGC and benign gastric ulcer and no patients died of disseminated disease. In comparison, five-year survival without surgery was only 64.5 percent in one series from Japan due to progression to invasive disease . These values are still better than the 15 to 44 percent five-year survival with advanced gastric cancer, indicating the EGC may be an earlier stage of disease with a long latent period .

Video Endoscopic Sequence 3 of 21.

 As proposed by the Japanese Society of
 Gastroenterological Endoscopy in 1962, early gastric
 cancer (EGC, also called superficial spreading carcinoma)
 is defined as adenocarcinoma limited to the gastric mucosa
 and submucosa regardless of whether regional lymph nodes
 are involved or not. This definition reflected an
 appreciation that EGC represented a subset of gastric
 cancers that had a favorable prognosis. Survival rates of 85
 to more than 90 percent five years after resection have
 been reported in Japan and the West . In one series from
 Europe, for example, survival was similar for EGC and
 benign gastric ulcer and no patients died of disseminated
 disease. In comparison, five-year survival without surgery
 was only 64.5 percent in one series from Japan due to
 progression to invasive disease . These values are still
 better than the 15 to 44 percent five-year survival with
 advanced gastric cancer, indicating the EGC may be an
 earlier stage of disease with a long latent period.

Five days after a follow up endoscopy was performed.

Video Endoscopic Sequence 4 of 21.

Five days after a follow up endoscopy was performed.

Surgical resection of early gastric cancers offers an excellent (90-100%) chance of cure based on several Japanese series.

Video Endoscopic Sequence 5 of 21.

 Surgical resection of early gastric cancers offers an
 excellent (90-100%) chance of cure based on several
 Japanese series.

 

Tumor biology and carcinogenesis are active areas of research investigation. The management of gastric cancer requires a thorough understanding of gastric anatomy.

Video Endoscopic Sequence 6 of 21.

 Tumor biology and carcinogenesis are active areas of
 research investigation. The management of gastric cancer
 requires a thorough understanding of gastric anatomy.

 

Lugol chromoendoscopy.

Video Endoscopic Sequence 7 of 21.

Lugol Chromoendoscopy

 

Panoramic view of the gastric fundus with the tumor.

Video Endoscopic Sequence 8 of 21.

Panoramic view of the gastric fundus with the tumor.

Earlycagast9

Video Endoscopic Sequence 9 of 21.

 

Earlycagast10

Video Endoscopic Sequence 10 of 21.

 

Earlycagast11

Video Endoscopic Sequence 11 of 21.

 

Earlycagast12

Video Endoscopic Sequence 12 of 21.

 

Lymphatic nodules of the lesser curvature.

Video Endoscopic Sequence 13 of 21.

Lymphatic nodules of the lesser curvature.

Earlycagast14

Video Endoscopic Sequence 14 of 21.

 

Earlycagast15

Video Endoscopic Sequence 15 of 21.

 

Earlycagast16

Video Endoscopic Sequence 16 of 21.

 

Earlycagast17

Video Endoscopic Sequence 17 of 21.

 

Microscopic pictures of the malignant neoplasia with invasion of the submucosa.

Video Endoscopic Sequence 18 of 21.

Microscopic pictures of the malignant neoplasia with invasion of the submucosa.

Microscopic pictures of the malignant neoplasia with invasion of the submucosa.

Video Endoscopic Sequence 19 of 21.

Microscopic pictures of the malignant neoplasia with invasion of the submucosa.

Earlycagast21

Video Endoscopic Sequence 20 of 21.

 

Earlycagast22

Video Endoscopic Sequence 21 of 21.

 

Ulcerated and obstructed Adenocarcinoma. A 67 year-old female with gastric adenocarcinoma that obstructed the gastric antrum, infiltrated the gastric angle. Central necrosis and ulceration are appreciated.

Ulcerated and obstructed Adenocarcinoma.

 A 67 year-old female with gastric adenocarcinoma that
 obstructed the gastric antrum, infiltrated the gastric angle.
 Central necrosis and ulceration are appreciated.

 Obstructed Adenocarcinoma of the Gastric Antrum. A 62 year-old female with anemia and weight loss of more than 20 pounds. Gastric Adenocarcinoma, ulcerated, with elevated margins that infiltrates the antrum and gastric angle.

 Obstructed Adenocarcinoma of the Gastric Antrum.

 A 62 year-old female with anemia and weight loss of more
 than 20 pounds.
 Gastric Adenocarcinoma, ulcerated, with elevated margins
 that infiltrates the antrum and gastric angle.

 
 

Ulcerated Gastric Adenocarcinoma of the incisura angularis.  An 81 year old female with abdominal pain and weight loss of 20 pounds.

Ulcerated Gastric Adenocarcinoma of the incisura angularis.

 An 81 year old female with abdominal pain and weight loss
 of 20 pounds.
 

 

Gastric Carcinoma that produces obstruction of the gastric body.

 Endoscopy of Gastric Adenocarcinoma

 Gastric Adeno-Carcinoma that produces obstruction of the
 gastric body.

Antrum Adenocarcinoma. A 61 year-old male. No weight loss neither vomiting had been reported.  An antrum adenocarcinoma with nearly complete occlusion was found. Multiples malign ulcers are observed at the antrum and corpus.

Antrum Adenocarcinoma.

 A 61 year-old male. No weight loss neither vomiting had
 been reported.
 An antrum adenocarcinoma with nearly complete
 occlusion was found. Multiples malign ulcers are observed
 at the antrum and corpus.
 
  

 Obstructed Adenocarcinoma. Gastric Carcinoma that produces antrum and distal body obstruction.

Obstructed Adenocarcinoma.

 Gastric Carcinoma that produces antrum and distal body
 obstruction.

A 51 year-old male, brother of  a well known pediatric surgeon, who asked us to perform an upper endoscopy, due to obstructive symptoms. We found an antrum carcinoma. The image displayed above is one year after initial diagnosis. The carcinoma proved to be inoperable. The image and video shown is after chemotherapy and  radiation used palliatively.

Video Endoscopic Sequence 1 of 2.

 A 51 year-old male, brother of a well known pediatric
 surgeon, who asked us to perform an upper endoscopy, due
 to obstructive symptoms. We found an antrum carcinoma.
 The image displayed above is one year after initial
 diagnosis.
 The carcinoma proved to be inoperable.
 The image and video shown is after chemotherapy and
 radiation used palliatively. 

Post surgical status of the previous case.

Video Endoscopic Sequence 2 of 2.

 Post surgical status of the previous case.

Gastric Adenocarcinoma of the Antrum. Carcinoma of the antrum causing high grade stenosis. Biliar reflux is observed that covers the necrosis.

Gastric Adenocarcinoma of the Antrum.

 Carcinoma of the antrum causing high grade stenosis.
 Biliar reflux is observed that covers the necrosis.

A 58 year-old female presenting with a carcinoma of the antrum with central necrosis.

Gastric Adenocarcinoma of the Antrum.

 A 58 year-old female presenting with a carcinoma of the
 antrum with central necrosis.

Obstructed Adenocarcinoma of the Antrum.  A 67 year-old female with obstructing gastric carcinoma of the antrum and distal corpus.

Obstructed Adenocarcinoma of the Antrum.

 A 67 year-old female with obstructing gastric carcinoma of
 the antrum and distal corpus.

Ulcerated adenocarcinoma of the antrum, causing nearly complete occlusion.

Adenocarcinoma of the Gastric Antrum.

 Ulcerated adenocarcinoma of the antrum, causing nearly
 complete occlusion.

A 49 year-old male with obstructed carcinoma of the antrum with central necrosis.

Doughnut-shape Gastric Adenocarcinoma.

 A 49 year-old male with obstructed carcinoma of the
 antrum with central necrosis.

Gastric adenocarcinoma with Signet-ring cells.  A 77 year-old female with epigastric pain and weight loss of 21 pounds.

Gastric adenocarcinoma with Signet-ring cells.

 A 77 year-old female with epigastric pain and weight loss of
 21 pounds.

Gastric Carcinoma of the antrum.

Adenocarcinoma of the Gastric Antrum.

 

A 74 year-old female with carcinoma of the antrum causing  high-grade stenosis.

Adenocarcinoma of the Gastric Antrum.

 A 74 year-old female with carcinoma of the antrum causing
 high-grade stenosis.

Adenocarcinoma of thePylorus A 67 year-old woman, with gastric carcinoma of the antrum.

 Adenocarcinoma of thePylorus.

 A 67 year-old woman, with gastric carcinoma of the
 antrum.

 
 

Adenocarcinoma of the Gastric Antrum. A 47 year-old male with weight loss of 20 pounds and vomiting. Obstructing gastric adenocarcinoma of the antrum was found.

 Adenocarcinoma of the Gastric Antrum.

 A 47 year-old male with weight loss of 20 pounds and
 vomiting. Obstructing gastric adenocarcinoma of the
 antrum was found. 

Gastric adenocarcinoma that obstructed the antrum.  A 66 year-old male with persisting vomiting, weight loss and anorexia.

Gastric adenocarcinoma that obstructed the antrum.

 A 66 year-old male with persisting vomiting, weight loss
 and anorexia.

 

A 50 year-old female with obstructing carcinoma of the antrum.

Adenocarcinoma of the Gastric Antrum.

 A 50 year-old female with obstructing carcinoma of the
 antrum.
  

A 64 Year-old male, who complained of persisting vomiting,  weight loss of 17 pounds, his creatinine was found of 3.4  mg./dl and Hb. 11.0 mg./dl.   Large Carcinoma of the antrum causing high-grade  stenosis.

Adenocarcinoma of the Gastric Antrum.

 A 64 Year-old male, who complained of persisting vomiting,
 weight loss of 17 pounds, his creatinine was found of 3.4
 mg./dl and Hb. 11.0 mg./dl.

 Large Carcinoma of the antrum causing high-grade
 stenosis.
   

A 73 years old man, with weight loss more than 25 pounds, abdominal pain and vomiting. Obstructing Adenocarcinoma of the antrum.

Adenocarcinoma of the Gastric Antrum.

 A 73 years old man, with weight loss more than 25 pounds,
 abdominal pain and vomiting.
 Obstructing Adenocarcinoma of the antrum.
     

 A 60 year-old dumb deaf  woman with ulcerated carcinoma at the prepiloric antrum. Similar image but benign in nature is dispayed in  The Gastric Ulcer chapter.

 Adenocarcinoma of the Gastric Antrum.

 A 60 year-old dumb deaf woman with ulcerated
 carcinoma at the pre-pyloric antrum.
 Similar image but benign in nature is dispayed in The
 Gastric Ulcer chapter.     
 

Ulcerated Gastric Carcinoma of the antrum with signet ring cells.

 Adenocarcinoma of the Gastric Antrum.

 Ulcerated Gastric Carcinoma of the antrum with signet ring
 cells.

 A 70 year-old male, with abdominal pain, weight loss of more than 40 pounds and vomiting. Gastric Adenocarcinoma that invaded antrum, corpus and fundus was found.

 A 70 year-old male, with abdominal pain, weight loss of
 more than 40 pounds and vomiting.
 Gastric Adenocarcinoma that invaded antrum, corpus and
 fundus was found.

A 60 year-old male with Gastric Adenocarcinoma of the fundus.

  A 60 year-old male with Gastric Adenocarcinoma of the
 fundus. 

A 69 year-old male with Gastric Carcinoma of the cardias.

     
  A 69 year-old male with Gastric Adeno Carcinoma of the
 cardias. 

Ulcerated Adenocarcinoma of the fundus and the cardias. A 56 year-old male from the republic of Spain.  He had disphagia and epigastric pain.

Ulcerated Adenocarcinoma of the fundus and the cardias.

 A 56 year-old male from the republic of Spain.
 He had disphagia and epigastric pain.

Gastric Adenoarcinoma of the fundus. A 66 year-old male with weight loss of 22 pounds and disphagia anorexia and vomiting.

Gastric Adenoarcinoma of the fundus.

 A 66 year-old male with weight loss of 22 pounds and
 disphagia anorexia and vomiting.
  


 

A 48 year-old female with weight loss of 20 pounds and epigastric pain Signet-ring adenocarcinoma of the gastric body and fundus.

 A 48 year-old female with weight loss of 20 pounds and
 epigastric pain

  Signet-ring adenocarcinoma of the gastric body and
  fundus.

                      

 

Gastric Adenocarcinoma of the Antrun A 59 year-old male who came from the republic of Honduras, to be evaluated for abdominal pain and weight loss of 20 pounds.

            Video Endoscopic Sequence 1 of 2.

 Gastric Adenocarcinoma of the Antrun
 A 59 year-old male who came from the republic of
 Honduras, to be evaluated for abdominal pain and weight
 loss of 20 pounds.

The antrum is deformed, the margin of the tumor are elevated.

          Video Endoscopic Sequence 2 of 2.

 The antrum is deformed, the margin of the tumor are
 elevated.

 

Gastric Adenocarcinoma of the Fundus. An 84 year-old female with abdominal pain and weigh loss. An ulcerated neoplasia in the fundus with hemorrhage is observed.

Gastric Adenocarcinoma of the Fundus.

 An 84 year-old female with abdominal pain and weigh loss.
 An ulcerated neoplasia in the fundus with hemorrhage is
 observed.  

A 62 year-old female with multinodular goiter present with nausea, vomiting and abdominal pain. She came to our office with her family physician who asked to perform her an upper endoscopy. The endoscopic image displays a radial nodularity with smooth tissue of the gastric antrum, There are some retraction of the antrum with a pseudo diverticula.

Video Endoscopic Sequence 1 of 3.

 A 62 year-old female with multinodular goiter present with
 nausea, vomiting and abdominal pain. She came to our
 office with her family physician who asked to perform her
 an upper endoscopy.
 The endoscopic image displays a radial nodularity with
 smooth tissue of the gastric antrum, There are some
 retraction of the antrum with a pseudo diverticula.

The image displays obtaining some biopsies of the neoplasia.

Video Endoscopic Sequence 2 of 3.

 The image displays obtaining some biopsies of the
 neoplasia.

The image and the video clip display a ulcerated deforming  antrum.

Video Endoscopic Sequence 3 of 3.

 The image and the video clip display a ulcerated deforming
 antrum.

 

A 75 year-old woman with ulcerated and infiltrating gastric carcinoma.

 A 75 year-old woman with ulcerated and infiltrating gastric
 carcinoma.

 
 

A 62 year-old male with diffuse gastric carcinoma with  superficial mucosal necrosis.

 A 62 year-old male with diffuse gastric carcinoma with
 superficial mucosal necrosis
.

62 year old male with obstructing Gastric Carcinoma.

 62 year old male with obstructing Gastric Carcinoma.

 

An 84 year-old male with weight loss of 40 pounds.  Gastric Adenocarcinoma of the fundus.

 Gastric Adenocarcinoma of the fundus.

 An 84 year-old male with weight loss of 40 pounds.

 Ulcerated Adenocarcinoma. A  36 year-old male with ulcerated adenocarcinoma of the posterior wall of the corpus.

 Ulcerated Adenocarcinoma.

 A 36 year-old male with ulcerated adenocarcinoma of the
 posterior wall of the corpus.

A 74 year-old man, with weight loss and vomiting abdominal ultrasonography revealed that the stomach wall were thickened. Endoscopically a gastric carcinoma of the corpus is seen. A cardial polyp is appreciated in the video clip.

Video Endoscopic Sequence 1 of 2.

 A 74 year-old man, with weight loss and vomiting abdominal
 ultrasonography revealed that the stomach wall were
 thickened.
 Endoscopically a gastric carcinoma of the corpus is seen.
 A cardial polyp is appreciated in the video clip.

For more Endoscopic details download the video clip by clicking on the endoscopic image.

Video Endoscopic Sequence 2 of 2.

There is a malignat gastric glandular neoplasia, tubular  (Intestinal Type). 
 There is a malignat gastric glandular neoplasia, tubular
 (Intestinal Type).

This 72 year-old male smoker, has been suffering of intractable  hiccups weight loss of 40 pounds, nausea and vomiting the biopsies display gastric adenocarcinoma of the intestinal type. The incidence of persistent hiccup in patients with advanced cancer is unknown but considered to be small.

Video Endoscopic Sequence 1 of 5.

 This 72 year-old male smoker, has been suffering of
 intractable hiccups weight loss of 40 pounds, nausea and
 vomiting the biopsies display gastric adenocarcinoma of
 the intestinal type. The incidence of persistent hiccup in
 patients with advanced cancer is unknown but considered
 to be small.

Retroflexed image, observing the neoplasia that infiltrates the gastric cardias.

Video Endoscopic Sequence 2 of 5.

Retroflexed image, observing the neoplasia that infiltrates the gastric cardias.

 

More images of the gastric cardias.

Video Endoscopic Sequence 3 of 5.

Endoscopy of Gastric Adenocarcinoma

More images of the gastric cardias.

 

Persistent or intractable hiccups are commonly associated with an underlying disease. Hiccups are caused by irritation of visceral afferent fibres of the vagus nerve or by direct irritation of the diaphragm.

Video Endoscopic Sequence 4 of 5.

 Persistent or intractable hiccups are commonly associated
 with an underlying disease. Hiccups are caused by
 irritation of visceral afferent fibres of the vagus nerve or
 by direct irritation of the diaphragm. Various definitions of
 hiccups can be found in the literature. A consensus is 'the
 repeated, involuntary, spasmodic contraction of the
 diaphragm and inspiratory muscles followed by sudden
 closure of the glottis' The medical term for hiccup –
 singultus – stems from the Latin word singult, which means
 catching one's breath while sobbing.

Hiccupping is a characteristic noise caused by a sudden closure of the glottis after repeated, involuntary, spasmodic contraction of the respiratory muscles. Hiccupping caused by gastric distention, spicy foods, and neural dysfunction often resolves itself without any treatment. Some hiccups are associated with certain diseases or occur postsurgically, and life-restricting intractable hiccups should be treated. The cause of hiccups should be expressly stated for treatment.

Video Endoscopic Sequence 5 of 5.

 Hiccupping is a characteristic noise caused by a sudden
 closure of the glottis after repeated, involuntary,
 spasmodic contraction of the respiratory muscles.
 Hiccupping caused by gastric distention, spicy foods, and
 neural dysfunction often resolves itself without any
 treatment. Some hiccups are associated with certain
 diseases or occur postsurgically, and life-restricting
 intractable hiccups should be treated. The cause of hiccups
 should be expressly stated for treatment.

 

Recurrent Gastric Cancer after Gastrectomy Billroth II.  This 65 year-old female 3 years previously underwent a gastrectomy Billroth II due to a gastric carcinoma of the antrum, one month previously of this endoscopy began with dysphagia, patient was referred to our endoscopic unit for evaluation. Extensive neoplastic infiltration of the fundus and cardias, retroflexed image.

Video Endoscopic Sequence 1 of 6.

Recurrent Gastric Cancer after Gastrectomy Billroth II

 This 65 year-old female, 3 years previously underwent a
 gastrectomy Billroth II due to a gastric adenocarcinoma of
 the antrum, one month previously of this endoscopy began
 with dysphagia, patient was referred to our endoscopic unit
 for evaluation.

 Extensive neoplastic infiltration of the fundus and cardias,
 retroflexed image.

Post surgical appearance observing three suture granulomas.   Suture granulomas can occur after gastric surgery with nonabsorbable suture material. They are usually an asymptomatic, incidental finding on post-surgical x-ray studies, but have to be recognized because their radiological appearance may mimic gastric neoplasms and therefore may lead to unnecessary reoperations.

Video Endoscopic Sequence 2 of 6.

Post surgical appearance observing three suture granulomas.

 Suture granulomas can occur after gastric surgery with
 nonabsorbable suture material. They are usually an
 asymptomatic, incidental finding on post-surgical x-ray
 studies, but have to be recognized because their
 radiological appearance may mimic gastric neoplasms and
 therefore may lead to unnecessary reoperations.

Retroflexed image, the video clip shows the gastric fundus totally infiltrated with this cancer.   Patients with recurrent gastric cancer have cancer that has returned after primary treatment. Patients with refractory gastric cancer have cancer that has stopped responding to primary or secondary treatments.  Old age and peritoneal recurrence negatively influenced on survival from recurrence for patients who had underwent curative gastrectomy for gastric cancer.

Video Endoscopic Sequence 3 of 6.

Retroflexed image, the video clip shows the gastric fundus totally infiltrated with this cancer.

Patients with recurrent gastric cancer have cancer that has returned after primary treatment. Patients with refractory gastric cancer have cancer that has stopped responding to primary or secondary treatments.

 Old age and peritoneal recurrence negatively influenced
 on survival from recurrence for patients who had
 underwent curative gastrectomy for gastric cancer.

The video clip shows suture granulomas magnyfing image.  Chemotherapy is the main treatment for patients who have residual cancer after surgery or experience a cancer recurrence after surgery. Single chemotherapy agents such as PlatinolŪ, 5-FU, MutamycinŪ, doxorubicin and EllenceŪ have been used for the treatment of gastric cancer for several years. However, these drugs result in clinical responses in less than half of patients with recurrent gastric cancer and virtually no complete responses are seen following single agent chemotherapy. The survival of patients treated with 5-FU-based chemotherapy combinations is less than one year. Recent clinical trials indicate that newer chemotherapy agents such as CamptosarŪ, GemzarŪ, TaxotereŪ and paclitaxel may be the most active single agents for the treatment of gastric cancer, with complete disappearance of cancer occurring in up to 15% of patients. Current clinical trials are evaluating various combinations of these newer drugs often in combination with PlatinolŪ and 5-FU.

Video Endoscopic Sequence 4 of 6.

The video clip shows suture granulomas magnyfing image.

 Chemotherapy is the main treatment for patients who have
 residual cancer after surgery or experience a cancer
 recurrence after surgery. Single chemotherapy agents
 such as Platinol®, 5-FU, Mutamycin®, doxorubicin and
 Ellence® have been used for the treatment of gastric
 cancer for several years. However, these drugs result in
 clinical responses in less than half of patients with
 recurrent gastric cancer and virtually no complete
 responses are seen following single agent chemotherapy.
 The survival of patients treated with 5-FU-based
 chemotherapy combinations is less than one year. Recent
 clinical trials indicate that newer chemotherapy agents
 such as Camptosar®, Gemzar®, Taxotere® and paclitaxel
 may be the most active single agents for the treatment of
 gastric cancer, with complete disappearance of cancer
 occurring in up to 15% of patients. Current clinical trials
 are evaluating various combinations of these newer drugs
 often in combination with Platinol® and 5-FU.

 

Due to the manipulation with the endoscope, the neoplasia initiates a slight bleeding that was controlled successfully with argon plasma APC.  Patients who experience a cancer recurrence following surgery can sometimes benefit from treatment with radiation therapy with or without chemotherapy. Radiation therapy can be extremely effective in temporarily controlling local symptoms from gastric cancer. In one clinical trial, 27 patients with inoperable gastric cancer were treated with chemotherapy and concurrent radiation therapy. The overall response rate was 56%, including 11% with a complete response. Two years following treatment, 29% of patients were alive without progression of their cancer. It was concluded from this clinical trial that combined chemotherapy and radiation therapy has substantial activity for the local control of advanced gastric cancer. Future clinical trials will continue to evaluate combinations of newer chemotherapy drugs and radiation with other local-regional and systemic treatments.

Video Endoscopic Sequence 5 of 6.

 Due to the manipulation with the endoscope, the neoplasia
 initiates a slight bleeding that was controlled successfully
 with argon plasma APC.

 Patients who experience a cancer recurrence following
 surgery can sometimes benefit from treatment with
 radiation therapy with or without chemotherapy. Radiation
 therapy can be extremely effective in temporarily
 controlling local symptoms from gastric cancer. In one
 clinical trial, 27 patients with inoperable gastric cancer
 were treated with chemotherapy and concurrent radiation
 therapy. The overall response rate was 56%, including
 11 % with a complete response. Two years following
 treatment, 29% of patients were alive without progression
 of their cancer. It was concluded from this clinical trial that
 combined chemotherapy and radiation therapy has
 substantial activity for the local control of advanced gastric
 cancer. Future clinical trials will continue to evaluate
 combinations of newer chemotherapy drugs and radiation
 with other local-regional and systemic treatments.

 

Therapeutic maneuver is being continued.       Prior to any surgical procedure, adequate preparation of the patient is important to minimize complications. Many patients with gastric cancer are malnourished at the time of diagnosis. Aggressive nutritional support has not been shown to improve long-term survival, but it has been shown to improve survival in the immediate post-operative period. Feeding intravenously and/or through a naso-gastric tube can enhance nutrition before surgery.

Video Endoscopic Sequence 6 of 6.

Therapeutic maneuver is being continued.

 Prior to any surgical procedure, adequate preparation of
 the patient is important to minimize complications. Many
 patients with gastric cancer are malnourished at the time
 of diagnosis. Aggressive nutritional support has not been
 shown to improve long-term survival, but it has been
 shown to improve survival in the immediate post-operative
 period. Feeding intravenously and/or through a
 naso-gastric tube can enhance nutrition before surgery.

 

Recurrent Gastric Cancer after Gastrectomy Billroth II.   This 67 year-old male, five year-previously underwent a gastrectomy Billroth II due to a gastric adenocarcinoma of the antrum in this follow up endoscopy founded a neoplasic infiltration in the lesser curvature.

Video Endoscopic Sequence 1 of 3.

Recurrent Gastric Cancer after Gastrectomy Billroth II

 This 67 year-old male, five year-previously underwent a
 gastrectomy Billroth II due to a gastric adenocarcinoma of
 the antrum in this follow up endoscopy founded a neoplasic
 infiltration in the lesser curvature.

Gastro-jejuno-anastomosis

Video Endoscopic Sequence 2 of 3.

Gastro-jejuno-anastomosis

 

More images and video clips.

Video Endoscopic Sequence 3 of 3.

More images and video clips.

 

Gastric Adenocarcinoma of the antrum that infiltrates the lesser curvature until near the fundus. This 47 year-old male, presented with weight loss of 40 pounds.

Video Endoscopic Sequence 1 of 3.

Gastric Adenocarcinoma of the antrum that infiltrates the lesser curvature until near the fundus.

This 47 year-old male, presented with weight loss of 40 pounds.

The images and video clips show a large ulcerated tumor.

Video Endoscopic Sequence 2 of 3.

The images and video clips show a large ulcerated tumor.

Cagastrico47x3

Video Endoscopic Sequence 3 of 3.

More images and video clips.

Early Gastric Adenocarcinoma, This 52 year-old female, presented this lesion at the antrum, the endoscopic ultrasound showed that lesion is limited at the mucosa and submucosa.

Video Endoscopic Sequence 1 of 5.

Early Gastric Adenocarcinoma

 This 52 year-old female, presented this lesion at the
 antrum, the endoscopic ultrasound showed that lesion is
 limited at the mucosa and submucosa.

This image shows irregular ulcerated adenocarcinoma

Video Endoscopic Sequence 2 of 5.

This image shows irregular ulcerated adenocarcinoma

Endoscopy of  Gastric Adenocarcinoma in the Early Phase

Video Endoscopic Sequence 3 of 5.

Endoscopy of Gastric Adenocarcinoma in the Early Phase

More images and video clips.

Endoscopy of  Gastric Adenocarcinoma in the Early Phase

Video Endoscopic Sequence 4 of 5.

Endoscopy of Gastric Adenocarcinoma in the Early Phase

Endoscopy of  Gastric Adenocarcinoma in the Early Phase

Video Endoscopic Sequence 5 of 5.

Endoscopy of Gastric Adenocarcinoma in the Early Phase

Adenocarcinoma of the fornix.  A 64 year-old male with adenocarcinoma of the fundus.

Adenocarcinoma of the fornix.

 A 64 year-old male with adenocarcinoma of the fundus.

Gastric Carcinoma that have been manifested with hiccups.  This 77 year old man with persistent hiccups. An infiltrating and ulcerated carcinoma of the body that invades the cardias is observed.

 

 Gastric AdenoCarcinoma that has been manifested with
 hiccups.

 This 77 year old man with persistent hiccups.
 An infiltrating and ulcerated carcinoma of the body that
 invades the cardias is observed.
 
There is a malignant gastric tubular Adenocarcinoma.

 There is a malignant gastric tubular adenocarcinoma.
 
 

 GastriA 74 year-old female, with dysphagia to solid food and weight  loss of  60 pounds. Gastric adenocarcinoma that protrude into the esophagus.

 Gastric Adenocarcinoma of the cardias.

 A 74 year-old female, with dysphagia to solid food and
 weight loss of 60 pounds. Gastric adenocarcinoma that
 protrude into the esophagus. More details Download the
 video clip.

   
    

Gastric carcinoma that has been extended upwards into to the middle portion of the esophagus. An 85 year-old male with progressive dysphagia and weight loss. The endoscopic procedure revealed a gastric carcinoma with an unusual presentation, showing itself as a large mass of  the fundus which extended upwards into to the middle portion of the esophagus.

 Gastric Adenocarcinoma that has been extended upwards
 into to the middle portion of the esophagus.


 An 85 year-old male with progressive dysphagia and
 weight loss.

 The endoscopic procedure revealed a gastric carcinoma
 with an unusual presentation, showing itself as a large mass
 of the fundus which extended upwards into to the middle
 portion of the esophagus.

                                           Medline.

Cauliflower-like Infiltrating Gastric Carcinoma.. A 94 year-old female with long history of epigastric pain, nausea, vomiting, sialorrea and weight loss.

Cauliflower-like Infiltrating Gastric Carcinoma.

 A 94 year-old female with long history of epigastric
 pain, nausea, vomiting, sialorrea and weight loss.

      

                                         

 

                                              Medline.
    

Advanced Gastric Carcinoma of the body.  A 54 year-old male who had been on treatment for a supposed gastritis by a general practitioner for more than a year. Patient did not reported weight loss.  The Gastrointestinal Video Endoscopy reveled advanced Gastric Carcinoma of the body.

Advanced Gastric Carcinoma of the body.

 A 54 year-old male who had been on treatment for a
 supposed gastritis by a general practitioner for more than
 a year. Patient did not reported weight loss.
 The Gastrointestinal Video Endoscopy reveled advanced
 Gastric Carcinoma of the body.
 
 

Gastric Carcinoma which exhibits a mass effect and  displays multiple ulcers.

    
 Gastric Adenocarcinoma which exhibits a mass effect and
 displays multiple ulcers.

Ulcerated Gastric Carcinoma of the body.  Gastrointestinal cancer is a major medical and economic burden worldwide. Esophageal and gastric cancers are most common in the non-industrialized countries, while colorectal cancer is the predominant gastrointestinal malignancy in westernized countries. Their aetiology is mainly related to correctable and preventable lifestyle habits; namely diet (including obesity), physical activity, alcohol and tobacco intake, and sanitation. Prevention and/or treatment of Helicobacter pylori infection would significantly reduce the prevalence of gastric cancer. Screening for cancer, its early detection and treatment requires medical facilities, Endoscopic expertise and a major investment of national financial resources. This is only feasible in affluent industrialized countries such as Japan for gastric cancer, some western countries for Esophageal and colorectal cancer. Only population screening for colorectal cancer has been proven feasible and cost-beneficial.

Ulcerated Gastric Carcinoma of the body.

 Gastrointestinal cancer is a major medical and economic
 burden worldwide. Oesophageal and gastric cancers are
 most common in the non-industrialized countries, while
 colorectal cancer is the predominant gastrointestinal
 malignancy in westernized countries. Their aetiology is
 mainly related to correctable and preventable lifestyle
 habits; namely diet (including obesity), physical activity,
 alcohol and tobacco intake, and sanitation. Prevention
 and/or treatment of Helicobacter pylori infection would
 significantly reduce the prevalence of gastric cancer.
 Screening for cancer, its early detection and treatment
 requires medical facilities, endoscopic expertise and a
 major investment of national financial resources. This is
 only feasible in affluent industrialized countries such as
 Japan for gastric cancer, some western countries for
 esophageal and colorectal cancer. Only population
 screening for colorectal cancer has been proven feasible
 and cost-beneficial.

Large Gastric Adenocarcinoma of the body with central necrosis.


 Large Gastric Adenocarcinoma of the body with central
 ulceration
 

Ulcerated Adenocarcinoma of the Body.

Ulcerated Adenocarcinoma of the Body.

 

Gastric Adenocarcinoma presented as two ulcers at  the antrum and angle.

Endoscopic Image of Gastric Cancer

 Gastric Adenocarcinoma presented as two ulcers at the
 antrum and angle.

Adenocarcinoma of the cardias extending into the  esophagus.

Video Endoscopic Sequence 1 of 2.

 Adenocarcinoma of the cardias extending into the
 esophagus.

Fundus Adenocarcinoma. The endoscope is retroflexed, You can see a gastric neoplasia that infiltrated the gastric cardias and the fornix.

Video Endoscopic Sequence 2 of 2.

Fundus Adenocarcinoma.

 The endoscope is retroflexed, You can see a gastric
 neoplasia that infiltrated the gastric cardias and the fornix.
   

Advanced Gastric Cancer. A large ulcerated mass is seen.

Advanced Gastric Cancer.

 A large ulcerated mass is seen.
 

Advanced adenocarcinoma of the corpus and fundus.

Infiltrating Adenocarcinoma.

 Advanced adenocarcinoma of the corpus and fundus.
 

Ulcerated Adenocarcinoma of the body.

Ulcerated Adenocarcinoma of the body.

 

Adenocarcinoma of the Gastric Antrum.  A 45 year-old female with carcinoma of the antrum and with obstructive signs. Nevertheless, the endoscopic diagnosis was delayed, because the patient had multiple anti ulcer treatment for over six months, having seen different physicians and receiving diverse treatments without any prior special diagnostic examinations, like an endoscopy, etc. This clinical history is repeated frequently, since many people believe that they have an ulcer or gastritis; or  being told so by their doctor or any particular person, without having any special  exams (I.e. endoscopy). One must always keep in mind that an ulcer or gastritis, treated with modern prescription medicine, improves greatly clinically, in as few as three or four days. Full recovery  is expected, within one month to six weeks after the beginning of the treatment. Any delay in clinical improvement is an important reason for concern and cancer must be ruled out by endoscopy.

 Adenocarcinoma of the Gastric Antrum.

 A 45 year-old female with carcinoma of the antrum and with
 obstructive signs. Nevertheless, the endoscopic diagnosis
 was delayed, because the patient had multiple anti ulcer
 treatment for over six months, having seen different
 physicians and receiving diverse treatments without any
 prior special diagnostic examinations, like an endoscopy,
 etc.


 
This clinical history is repeated frequently, since many
 people believe that they have an ulcer or gastritis; or
 being told so by their doctor or any particular person,
 without having any special exams (I.e. endoscopy).
 One must always keep in mind that an ulcer or gastritis,
 treated with modern prescription medicine, improves
 greatly clinically, in as few as three or four days. Full
 recovery
is expected, within one month to six weeks after
 the beginning of the treatment.

 Any delay in clinical improvement is an important reason
 for concern and cancer must be ruled out by endoscopy
.

 A 77 year-old male with Ulcerated Gastric adenocarcinoma with elevated  margins in the area of the corpus and antrum.

 Adenocarcinoma of the antrum

 A 77 year-old male with Ulcerated Gastric adenocarcinoma
 with elevated margins in the area of the corpus and
 antrum.

A 60 year-old male with extensive obstructing carcinoma.

 A 60 year-old male with extensive obstructing carcinoma.

Fornix Adenocarcinoma. Gastric ulcerated carcinoma of the fundus that causes mild hemorrhage.

 Fornix Adenocarcinoma.

 Gastric ulcerated carcinoma of the fundus that causes
 mild hemorrhage
.

Ulcerated and infiltrating adenocarcinoma.

               Extensive Gastric Carcinoma.

      Ulcerated and Infiltrating Adenocarcinoma.

 
 

Ulcerated and infiltrating gastric carcinoma. Helicobacter pylori: Antral gastritis caused by H pylori has been lined to the development of gastric cancer. Patients with H pylori gastritis are 3-6 times more likely to develop gastric cancer than individuals without the infection.

Ulcerated and infiltrating Gastric Adenocarcinoma.

 Helicobacter pylori: Antral gastritis caused by H pylori
 has been lined to the development of gastric cancer.
 Patients with H pylori gastritis are 3-6 times more likely to
 develop gastric cancer than individuals without the infection.

Gastric adenocarcinoma of the cardias.   A 76 year-old female with gastric Adenocarcinoma of the cardias

 Infiltranting Adenocarcinoma of the Cardias.

 A 76 year-old female with gastric adenocarcinoma of the
 cardias.

A 63 year-old male with weight loss of more than 40 pounds and vomiting. Obstructing Gastric Carcinoma of the Cardias is observed.

Obstructing Gastric Adenocarcinoma.

 A 63 year-old male with weight loss of more than 40 pounds
 and vomiting. Obstructing gastric adenocarcinoma of the
 cardias is observed.
 

Extensive infiltrating gastric adenocarcinoma. A 50 year-old female with abdominal pain and weight loss for a period of six months. Extensive infiltrating gastric carcinoma is observed.

Extensive infiltrating gastric adenocarcinoma.

 A 50 year-old female with abdominal pain and weight loss
 for a period of six months. Extensive infiltrating gastric
 carcinoma is observed.

Extensive infiltrating gastric adenocarcinoma. A 75 year-old woman with ulcerated and infiltrating gastric carcinoma of the corpus and fundus.

Extensive Infiltrating Gastric Adenocarcinoma.

 A 75 year-old woman with ulcerated and infiltrating gastric
 carcinoma of the corpus and fundus.

 

 

Gastric Carcinoma of distal corpus and the antrum.


 A 79 year-old male, weight loss more than 20 pounds
 gastric adenocarcinoma of distal corpus and the antrum.

 

A 75 year-old female with ulcerated gastric carcinoma of the antrum.

 A 75 year-old female with ulcerated gastric carcinoma of
 the antrum.

 Advanced Gastric Carcinoma that is observed as ulcerated  and infiltrating.

 Advanced Gastric Carcinoma that is observed as ulcerated
 and infiltrating.

A 62 year-old with ulcerated and infiltrating adenocarcinoma of the antrum.

 Infiltrating Adenocarcinoma of the Antrum.

 A 62 year-old with ulcerated and infiltrating
 adenocarcinoma of the antrum of the diffuse type. 
 

Polypoid Adenocarcinoma

Photography Sequence 1 of 9.

Polypoid Adenocarcinoma

 

 

 

Click on the image to enlarge in a new windows

 

More images

Photography Sequence 2 of 9.

More images

Image of Gastric Adenocarcinoma.

Photography Sequence 3 of 9.

Image of Gastric Adenocarcinoma

Image of Gastric Cancer

Photography Sequence 4 of 9.

Image of Gastric Cancer

Photography Sequence 5 of 9.

 

Photography Sequence 6 of 9.

 

Appearance of Gastric Carcinoma.

Photography Sequence 7 of 9.

Appearance of Gastric Carcinoma

Appearance of Gastric Cancer

Photography Sequence 8 of 9.

Appearance of Gastric Cancer

Photography Sequence 9 of 9.

 

CaAntrumBled1

Video Endoscopic Sequence 1 of 5.

Gastric Adenocarcinoma of the antrum

 

CaAntrumBled2

Video Endoscopic Sequence 2 of 5.

There are a small foci of bleeding that may cause the anemia.

 

CaAntrumBled3

Video Endoscopic Sequence 3 of 5.

 After the biopsies, there is a slight but continuous bleeding

CaAntrumBled4

Video Endoscopic Sequence 4 of 5.

 

CaAntrumBled5

Video Endoscopic Sequence 5 of 5.

Argon Plasma Coagulation for hemostatic Therapy