title: Adhesions due to peritoneal carcinomatosis caused by a renal carcinoma leading to mechanical gastric outlet obstruction: a case report.
abstract: BACKGROUND
  Gastric outlet obstruction is a clinical syndrome caused by a variety of mechanical obstructions. Peptic ulcer disease used to be responsible for most gastric outlet obstruction, but in the last 40 years the prevalence of malignant tumors has risen significantly. Adhesive disease is an infrequent and insidious cause of mechanical gastric outlet obstruction.
  
  
  METHODS
  We report the case of a 78-year-old Caucasian man who had a clinical history of a right nephrectomy for malignancy three years earlier and who was admitted for a severe gastric outlet obstruction (score of 1) confirmed both by an upper endoscopy and by a fluoroscopic view after contrast injection. A computed tomography scan and a laparotomy, with omental biopsies, showed a peritoneal carcinomatosis with the development of abdominal adhesions that prompted an abnormal gastric rotation around the perpendicular axis of his antrum with a dislocation in the empty space of his right kidney. Symptoms disappeared after surgical bypass through a gastrojejunostomy.
  
  
  CONCLUSIONS
  Our patient experienced a very rare complication characterized by the development of adhesions due to peritoneal carcinomatosis caused by a renal carcinoma treated with nephrectomy. These adhesions prompted an abnormal dislocation of his antrum, as an internal hernia, in the empty space of his right kidney.
authors.affiliation: Gastroenterology Unit, IsMeTT, UPMC, Via Tricomi 1, Palermo 90100, Italy. fmocciaro@gmail.com.
authors.forename: Filippo
authors.initials: F
authors.lastname: Mocciaro
authors.forename: Gabriele
authors.initials: G
authors.lastname: Curcio
authors.forename: Ilaria
authors.initials: I
authors.lastname: Tarantino
authors.forename: Luca
authors.initials: L
authors.lastname: Barresi
authors.forename: Gaetano
authors.initials: G
authors.lastname: Burgio
authors.forename: Salvatore
authors.initials: S
authors.lastname: Gruttadauria
authors.forename: Settimo
authors.initials: S
authors.lastname: Caruso
authors.forename: Mario
authors.initials: M
authors.lastname: Traina