Perforated Gastric Cancer Complicating Early Postpartum Period of Pregnancy

Abstract

Background: An unique association of gastric cancer with pregnancy and puerperium is rare. Case: A 29-year-old woman had complained of epigastric pain, postprandial vomiting and weight loss during the last 3 months of pregnancy. She first applied to our centre for premature rupture of membranes at the 38^th week of gestation and underwent an emergency caesarean section because of umblical cord prolapsus. The patient developed generalised abdominal pain, distention and fever on the 2^nd postpartum day. She was operated on due to acute abdomen. During surgery, generalised peritonitis with a gastric ulcer perforation at the corpus was found. The perforation area was repaired primarily. Pathological examination revealed gastric adenocarcinoma. Definitive surgery was carried out 2 weeks later. The patient received 6 cycles of adjuvant chemotherapy. After completing chemotherapy the patient was re-explored because of developing intestinal obstruction. In surgical exploration, a disseminated peritonitis carcinomatosa and extensive adhesions were observed and the patient was therefore evaluated as incurable. Postoperatively, the patient developed a high output intestinal fistula which could not be treated with palliative care. The patient died 6 months after initial diagnosis of gastric cancer.

Conclusion: When peritonitis symptoms exist in a postpartum woman in addition to other peritonitis causes, malignant gastro-intestinal perforations such as gastric cancer perforation should be kept in mind.

Key Words:

• Gastric cancer
• pregnancy.

Additional information

Notes on contributors

N. Erkan

N. Erkan, M.D., Associate Prof. 14 Sok. No: 18/14 35350 Ûçkuyular Izmir, Turkey Tel.: [phone] Fax: [phone] E-mail: [email protected]