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
Adenocarcinoma of the lesser curvature with signet-ring cells. This 34 year old female, lawyer  who 4 months previously delivered her second baby and has another baby of three years, due to an abdominal pain an upper endoscopy was performed, eight loss of 10 pounds is reported.

Video Endoscopic Sequence 1 of 8.

Adenocarcinoma of the lesser curvature with signet-ring cells.

 This 34 year old female, lawyer who 4 months previously
 delivered her second baby and has another baby of
three
 years, due to an abdominal pain an upper endoscopy was
 performed, w
eight loss of 10 pounds was reported.

 For further endoscopic information, by clicking on the
 endoscopic image. Wait to be downloaded complete then
 Press Alt and Enter for full screen ( Windows Media),
Real
 Player: Ctrl and 3.

 All endoscopic images shown in this Atlas contain
 video clips.
We recommend seeing the video clips in full
 screen mode.

Chromoendoscopy using Lugol's solution. At the gastric angle an irregular folders are found.The image and video display some typical parameters of criteria of a malign ulcer. 1. Fold tapering 2. Ulcer 3. Fusion of  folds 4. Abrupt termination of fold 5. Bulbous enlargement.

Video Endoscopic Sequence 2 of 8.

Chromoendoscopy using Lugol's solution.

 At the gastric angle an irregular folders are found.

 The image and video display some typical parameters of
 criteria of a malign ulcer.

 1. Fold tapering
 2. Ulcer
 3. Fusion of folds
 4. Abrupt termination of fold
 5. Bulbous enlargement.

 

In this image and video clip is observed an irregular ulceration found it at the lesser curvature and the anterior wall of the stomach.

Video Endoscopic Sequence 3 of 8.

 In this image and video clip is observed an irregular
 ulceration found it at the lesser curvature and the anterior
 wall of the stomach which fulfill of criteria of a malign
 infiltration

 

Another image of the folds that converges in abnormal form.

Video Endoscopic Sequence 4 of 8.

 Another image of the folds that converges in abnormal
 form.

 

Retroflexed Image

Video Endoscopic Sequence 5 of 8.

Retroflexed Image.

Magnifying Endoscopy 150x.. Some ulcerated areas with neovascularization.

Video Endoscopic Sequence 6 of 8.

Magnifying Endoscopy 150x.

 Some ulcerated areas with neovascularization
 are observed.

 

Chromoendoscopy using indigo carmin

Video Endoscopic Sequence 7 of 8.

Chromoendoscopy using indigo carmin.

Magnifying Endoscopy 150x. . Some ulcerated areas with neovascularization, ulcerated areas, and cellular agglomerate are seen.

Video Endoscopic Sequence 8 of 8.

Magnifying Endoscopy 150x.

 Some ulcerated areas with neovascularization, ulcerated
 areas, and cellular agglomerate are seen.

 

Adenocarcinoma of the lesser curvature with signet-ring cells. This 56 year-old man, who two months previously initiates sintomatology with loss weight, satiety and postprandial vomiting.

Video Endoscopic Sequence 1 of 3.

Adenocarcinoma of the lesser curvature with signet-ring cells.

 This 56 year-old man, who two months previously initiates
 sintomatology with loss weight, satiety and postprandial
 vomiting.

 

In this image and video clip is seen an irregular ulceration of the body and antrum.

Video Endoscopic Sequence 2 of 3.

 In this image and video clip is seen an irregular ulceration
 of the body and antrum.

In this image as well as the video clip you can seen another view of the neoplasia

Video Endoscopic Sequence 3 of 3.

 In this image as well as the video clip you can seen another
 view of the neoplasia.

In this endoscopic sequence a reflux esophagitis is observed due to an obstructed gastric cancer of the antrum.

Video Endoscopic Sequence 1 of 3.

 In this endoscopic sequence a reflux esophagitis is
 observed due to an obstructed gastric cancer of the antrum.

An ulcerated obstructed neoplasia is seen at the gastric antrum.  This 56 year- old male,  who presented with early satiety and postprandial vomiting, suggestive of gastric outlet obstruction, along with weight loss and anemia. Endoscopy demonstrated an ulcerated mass.

Video Endoscopic Sequence 2 of 3.

An ulcerated obstructed neoplasia is seen at the gastric antrum.

 This 56 year- old male, who presented with early satiety
 and postprandial vomiting, suggestive of gastric outlet
 obstruction, along with weight loss and anemia. Endoscopy
 demonstrated an ulcerated mass.

.

Biopsy revealed the lesion to be adenocarcinoma.

Video Endoscopic Sequence 3 of 3.

Biopsy revealed the lesion to be adenocarcinoma

 

 

krukenberg´s Tumor.   A 56 year-old female, gynecologist doctor, underwent a laparotomy due to ovarian tumor, at surgery a gastric  carcinoma was detected.

Video Endoscopic Sequence 1 of 2.

 krukenberg´s Tumor.

 A 56 year-old female, gynecologist doctor, underwent a
 laparotomy due to ovarian tumor, at surgery, a gastric
 adenocarcinoma was detected.

  F. E. Krukenberg:er das Fibrosarcoma ovarii mucocellulare
 (carcinomatodes).
Archiv für Gynäkologie,
 Berlin, 1896, 50: 287-321.                                                                                                        Medline.

The carcinoma proved to be inoperable. The image and video clip shows the post surgical status, only a anastomosis was performed both ovaries have been infiltrated.  In 1896 Krukenberg described what he presumed was a new type of primary ovarian neoplasm. The true metastatic nature of this lesion was established six years later. Some 5 – 10% of all ovarian malignant lesions are regarded as metastatic. Of them approximately 50% are Krukenberg tumours, which have well defined histologic characteristics (carcinoma with signet-ring cells and stroma with sarcomatoid reaction). Krukenberg tumor is secondary to a neoplastic process in the gastrointestinal tract. The stomach is the commonest primary site (2% of all women with gastric cancer develop ovarian metastasis), followed by the colon. Gallbladder, biliary ducts and appendix can also be the source of the primary neoplasm.

Video Endoscopic Sequence 2 of 2.

 The carcinoma proved to be inoperable.
 The image and video clip shows the post surgical status.
 Only a anastomosis was performed. Both ovaries have
 been infiltrated.

 In 1896 Krukenberg described what he presumed was a new
 type of primary ovarian neoplasm. The true metastatic nature of
 this lesion was established six years later. Some 5 – 10% of all
 ovarian malignant lesions are regarded as metastatic. Of them
 approximately 50% are Krukenberg tumours, which have well
 defined histologic characteristics (carcinoma with signet-ring cells
 and stroma with sarcomatoid reaction). Krukenberg tumor is
 secondary to a neoplastic process in the gastrointestinal tract.
 The stomach is the commonest primary site (2% of all women
 with gastric cancer develop ovarian metastasis), followed by the
 colon. Gallbladder, biliary ducts and appendix can also be the
 source of the primary neoplasm.

A 52 year-old female with epigastric pain and vomiting. No weight loss was reported. The morphological appearance was that of a big ulcer with suspected malignancy, however multiple biopsies of the first endoscopy did not reveal any malignant cells.  Our  recommendation was a repeat the endoscopy in six week.  Ulcerated Gastric Carcinoma at the gastric angle was found.

Video Endoscopic Sequence 1 of 2.

 A 52 year-old female with epigastric pain and vomiting.
 No weight loss was reported. The morphological
 appearance was that of a big ulcer with suspected
 malignancy. However, multiple biopsies of the first
 endoscopy did not reveal any malignant cells.
 
Our recommendation was a repeat the endoscopy in six
 week.
 Ulcerated Gastric Carcinoma at the gastric angle was
 found.

 

Same case as above, the patient did not  improve her symptoms. We recommended a new endoscopy after the treatment. The malignant appearance became even more obvious after two months Biopsies of gastric ulcer must be taken at least twice, even when only an ulcer scar is visible at  the second examination. This is because often the presence of abundant necrosis causes false negative  biopsies.

Video Endoscopic Sequence 2 of 2.

 Same case as above. The patient did not improve her
 symptoms. We had recommended a new endoscopy after
 the treatment. The malignant appearance became even
 more obvious after two months.
 Biopsies of gastric ulcer must be taken at least twice, even
 when only an ulcer scar is visible at the second
 examination. This is because often the presence of
 abundant necrosis causes false negative biopsies.

                Click here to see the microscopic images

Ulcerated carcinoma of the gastric body. A 79 year-old female who complained of severe epigastric pain and weight loss of 20 pounds. The video endoscopic procedure revealed an ulcerated carcinoma of the gastric  body.  All cases shown in this atlas are patients that I have personally seen in my private practice, where I have observed a very high incidence of gastric cancer. Patients of a low socioeconomic status, normally seen at public or charity hospitals, have an even higher incidence of this disease.

Video Endoscopic Sequence 1 of 2.

Ulcerated Adenocarcinoma of the gastric body.

 A 79 year-old female who complained of severe epigastric
 pain and weight loss of 20 pounds. The video endoscopic
 procedure revealed an ulcerated carcinoma of the gastric
 body.
 All cases shown in this atlas are patients that I have
 personally seen in my private practice,
where I have
 observed a very high incidence of gastric cancer. Patients
 of a low socioeconomic status, that are seen at public or
 charity hospitals, have an even higher incidence of this
 disease.

Bleeding is observed, the ulcerated carcinoma at the greater curvature.

Video Endoscopic Sequence 2 of 2.

 Bleeding is observed, the ulcerated adenocarcinoma at the
 greater curvature.

Ulcerated Gastric Adenocarcinoma of the gastric incisure. A 60 year-old female with weight loss and vomiting. Ulcerated Gastric Adenocarcinoma of the gastric incisure with signet ring cell.

Ulcerated Gastric Adenocarcinoma of the gastric incisure.

 A 60 year-old female with weight loss and vomiting.
 Ulcerated Gastric Adenocarcinoma of the gastric incisure
 with signet ring cell.
 
 

Ulcerated Gastric Carcinoma. A 66 year-old male with abdominal pain, nausea, Vomiting and weight loss. An ulcerated gastric carcinoma at the corpus was found.

Ulcerated Gastric Carcinoma.

 A 66 year-old male with abdominal pain, nausea,
 Vomiting and weight loss.
 An ulcerated gastric carcinoma at the corpus was found.
 
 

A 57 year-old female who had history of a previous upper gastrointestinal endoscopies over several years, performed elsewhere. On her visit to our clinic, she complained of epigastric pain and disuria. A severe urinary tract infection was detected and ciprofloxacine was prescribed. The next morning an upper gastrointestinal endoscopy was performed, a tablet of ciprofloxacine taken at 3 am, was found at the cardias ( endoscopy was performed at 9.11 am) The tablet still seen in the esophagus, which is not considered normal, since food and  medicines travel immediately to the stomach after being ingested. Thus, suspicion of a disease in this region arises.

Video Endoscopic Sequence 1 of 2.

 A 57 year-old female who had history of a previous upper
 gastrointestinal endoscopies over several years,
 performed elsewhere. On her visit to our clinic, she
 complained of epigastric pain and disuria. A severe urinary
 tract infection was detected and ciprofloxacine was
 prescribed. The next morning an upper gastrointestinal
 endoscopy was performed, a tablet of ciprofloxacine taken
 at 3 am, was found at the cardias ( endoscopy was
 performed at 9.11 am) The tablet still seen in the
 esophagus, which is not considered normal, since food and
 medicines travel immediately to the stomach after being
 ingested.
Therefore, the suspicion of a disease in this
 region arises

 
        

Ulcerated Gastric Carcinoma of the fundus retroflexed view.

             Video Endoscopic Sequence 2 of 2.
 
 Ulcerated Gastric Carcinoma of the fundus retroflexed
 view.

Adenocarcinoma of the cardias and gastric fundus with signet-ring cells. A 34 year-old male, who presented dysphagia for solids and liquids.

Video Endoscopic Sequence 1 of 17.

Adenocarcinoma of the cardias and gastric fundus with signet-ring cells.

A 34 year-old male, who presented dysphagia for solids and liquids.

 

In the retroflexed image a large ulcerated tumor is observed at the gastric fundus.

Video Endoscopic Sequence 2 of 17.

 In the retroflexed image a large ulcerated tumor is observed at the gastric fundus.

The gastric cardias is observed with extensive infiltration.

Video Endoscopic Sequence 3 of 17.

The gastric cardias is observed with extensive infiltration.

More images and video clips.

Video Endoscopic Sequence 4 of 17.

More images and video clips.

There is an ulcer at the gastroesophageal junction. The antral mucosa  is edematous.

Video Endoscopic Sequence 5 of 17.

There is an ulcer at the gastroesophageal junction.
 The antral mucosa is edematous.

This view shows the irregular border of the ulcer at the esophagogastric junction.

Video Endoscopic Sequence 6 of 17.

This view shows the irregular border of the ulcer at the esophagogastric junction.

 

It is shown the fundus of the neoplasia with irregular and granular surface.

Video Endoscopic Sequence 7 of 17.

 It is shown the fundus of the neoplasia with irregular and
 granular surface.

This view shows the irregular border of the ulcer at the esophagogastric junction.

Video Endoscopic Sequence 8 of 17.

 This view shows the irregular border of the ulcer
 at the esophagogastric junction.

   

It is shown the fundus of the neoplasia with irregular and granular surface

Video Endoscopic Sequence 9 of 17.

It is shown the fundus of the neoplasia with irregular and granular surface.

There is a slight malignant epithelial  infiltrate into the lamina propria.

Video Endoscopic Sequence 10 of 17.

There is a slight malignant epithelial infiltrates into the lamina propria.

 

It is clearly visible the malignant epithelial cells at the muscular propria.

Video Endoscopic Sequence 11 of 17.

It is clearly visible the malignant epithelial cells at the muscular propria.

There are mucosecreting malignant glands.

Video Endoscopic Sequence 12 of 17.

There are mucosecreting malignant glands.

 

There are malignant epithelial cells, some of them wit clear cytoplasm.

Video Endoscopic Sequence 13 of 17.

There are malignant epithelial cells, some of them wit clear cytoplasm.

Picture of a metastatic glandular neoplasia to lymph nodes.

Video Endoscopic Sequence 14 of 17.

Picture of a metastatic glandular neoplasia to lymph nodes.

 

The ring shape of the epithelial malignant cells is the predominant histologic pattern.

Video Endoscopic Sequence 15 of 17.

The ring shape of the epithelial malignant cells is the predominant histologic pattern.

Picture of a metastatic glandular neoplasia to lymph nodes.

Video Endoscopic Sequence 16 of 17.

Picture of a metastatic glandular neoplasia to lymph nodes.

 

One year after the surgery a follow up endoscopy was performed finding this malign nodule at the distal esophagus.

Video Endoscopic Sequence 17 of 17.

 One year after the surgery a follow up endoscopy was
 performed finding this malign nodule at the distal
 esophagus.