Gastric functional disorders in patients with various hemodynamic types of acute myocardial infarction

The paper is concerned with the results of investigation of acid- and enzyme-producing, motor and evacuatory function of the stomach on days 2, 10-15, 28-35 after myocardial infarction. Correlation of the type and severity of gastric dysfunction and the type of hemodynamic reactions developing in myocardial infarction, was established. The most serious and prolonged disorders were detected in patients with hyper- and especially hypodynamic disorders of central hemodynamics which were indicative of close relationships between the type of hemodynamic reactions in myocardial infarction and gastric function. Drug correction of gastric dysfunction in myocardial infarction is achieved by administration of sulpiride and protein-oxygen cocktails which are recommended for prophylactic purposes.     

Gastric remnant infarction following laparoscopy-assisted distal gastrectomy: CT diagnosis in two cases

We report two cases of gastric remnant infarction following laparoscopy-assisted distal gastrectomy for the treatment of early gastric cancer. In both cases, the infarction was diagnosed with contrast-enhanced computer tomography.     

Gastric Ulcer

Because 10 to 20 per cent of gastric ulcers prove to be malignant at operation, it is important to decide clinically whether a gastric ulcer is definitely benign or has a strong potential of being malignant. The size of the ulcer, its location and the patients age are not sufficient criteria for such a differential diagnosis. Most patients with gastric ulcer should be hospitalized for a trial of medical treatment. If the ulcer fails to heal, if it recurs, or if there is occult blood in the stool, surgical treatment is indicated. About 50 per cent of patients with gastric ulcer will need operation.     

Gastric sarcoidosis

Sarcoidosis of the gastrointestinal tract is uncommon even though involvement of the liver, spleen, and adenopathy are becoming recognizable entities on computed tomography (CT). Involvement of the stomach, the most common site of sarcoidosis of the gastrointestinal tract, is usually associated with pulmonary disease. The radiologic appearances of gastric involvement are variable. Positive biopsies may be obtained in a radiologically normal stomach. Ulceration resembling peptic ulcer disease may occur, and mucosal enlargement may be minor, diffusely nodular, or significant enough to mimic Menetrier disease. In its most dramatic form, a linitis plastica appearance resembling scirrhous carcinoma has been reported. Received: 10 October 1995/Accepted after revision: 31 January 1996     

Gastric syphilis

A sexually transmitted disease is seldom considered in the differential diagnosis of patients with clinical gastritis. A patient with gastric syphilis is reported to alert emergency department physicians to this entity. History and physical findings of syphilis should be sought and rapid plasma reagin tests should be obtained in the patient with severe or refractory gastritis.     

Gastric lavage

Gastric lavage has been used to manage toxic ingestions since the early 1800s. The entire realm of gastrointestinal decontamination has been extensively studied for the past 30 years. Recommendations are still evolving and remain controversial. The current indications for lavage are obtundation, unprotected airway, seizures, the need for urgent removal, and the tendency to form concretions. Hydrocarbon management depends on specific toxicity and viscosity. Contraindications for this procedure are insignificant ingestions, prolonged time since ingestion, and caustic poisoning. Proper technique minimizes complications and maximizes toxin removal. Activated charcoal and a cathartic are given after lavage. Complications include nasal trauma, esophageal perforation, tracheal intubation, aspiration, electrolyte imbalance, and hypothermia.     

Gastric cancer

Gastric cancer is a very challenging malignancy given that it presents late, has complex pathogenetic mechanisms with multiple carcinogenic processes implicated, and is only moderately sensitive to chemotherapy and radiation. Accurate staging for gastric cancer is possible with the availability of sophisticated imaging studies, endoscopic ultrasound, and laparoscopy. Postoperative chemoradiation is the standard of care in high-risk patients with resected primary disease. Recent encouraging results with the preoperative approach need to be studied further and prospectively compared to postoperative chemoradiation. Chemotherapy has yielded better results than best supportive care for metastatic gastric cancer and also improves quality of life, although all of these studies included a small number of patients. The last decade has seen newer agents used alone or in combination, with promising results. We anticipate that improved trial design, availability of molecular techniques, and continued search for better cytotoxic and targeted agents will help develop better treatments for patients with advanced gastric cancer.     

Gastric cancer

OBJECTIVES: To review the current status, recent advances, and ongoing research related to screening, diagnosis, staging, and treatment of gastric cancer. DATA SOURCES: Professional journals, research studies, and review articles relating to gastric cancer. CONCLUSIONS: Surgical resection is the gold standard curative treatment for gastric cancer; however, diagnosis is often at later stages of disease, leaving poor long-term survival rates. An emphasis has been placed on developing more effective chemotherapy regimens; currently, fluorouracil is the standard single agent used for gastric cancer. Radiation therapy has been used for palliative symptom management. IMPLICATIONS FOR NURSING PRACTICE: An understanding of current treatment modalities for gastric cancer will help oncology nurses assist their patients throughout their course of treatment with education, nutritional support, and symptom control.