title: Complex histopathological and surgical aspects in a case of giant malignant gastric perforation.
abstract: We present the case of a 52-year-old male patient, hospitalized on an emergency basis in the University Emergency Hospital in Bucharest, after being diagnosed with pneumoperitoneum acute abdomen, for which emergency surgery was mandatory. A 3,5-4 cm malignant gastric perforation, ascitis and peritoneal carcinomatosis were found. The histopathological exam revealed infiltrative mucinous gastric carcinoma with epiploic metastasis. Due to the lack of available gastric material, an atypical surgical solution was performed: gastric packing with epiploic material by means of transgastric traction. The solution proved to be successful for short-term recovery. The underlying condition was not focused on, the patient being directed to the Oncology Department. Acute gastric perforation is a rare complication of gastric cancer, and the association with gastric linitis is uncommon. This specific histopathological condition made the classical surgical repair techniques unsuitable for the presented case and an atypical solution had to be performed.
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: D
authors.initials: D
authors.lastname: Serban
authors.affiliation: University Emergency Hospital, Upper Digestive Surgery Clinic, Bucharest, Romania.
authors.forename: C
authors.initials: C
authors.lastname: Branescu
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: C
authors.initials: C
authors.lastname: Savlovschi
authors.affiliation: University Emergency Hospital, Upper Digestive Surgery Clinic, Bucharest, Romania.
authors.forename: A
authors.initials: A
authors.lastname: El-Khatib
authors.affiliation: University Emergency Hospital, Upper Digestive Surgery Clinic, Bucharest, Romania.
authors.forename: C
authors.initials: C
authors.lastname: Tudor
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: A
authors.initials: A
authors.lastname: Nica
authors.affiliation: University Emergency Hospital, Upper Digestive Surgery Clinic, Bucharest, Romania.
authors.forename: A
authors.initials: A
authors.lastname: Kraft
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: A M
authors.initials: AM
authors.lastname: Dascalu
mesh_terms: D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D012421:Rupture / Q000473:pathology* / Q000601:surgery*; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*
keywords: mucinous gastric cancer; omentoplasty; perforation; surgery