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Ulcerative disease of the stomach and duodenum
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Abstract— Gastrointestinal stromal tumors (GIST) are rare neoplasms of the gastrointestinal system. A case of 40 year old man having tense tender abdomen with obliterated liver dullness and shifting dullness was presented in emergency, it was further investigated on X rays, where pneumoperitoneum was found. This case was then decided to go for Laparatomy after routine investigations to further explore. On exploratory laparatomy, diffuse peritonitis with brown coloured fluid was observed. A 10 x 5 x 7 cm mass was found having an opening communicating with the gut lumen was present around 10 cm from the ligament of treitz. However, no adjacent structures, liver or parietal peritoneum seemed to be involved. Gross examination of the specimen revealed an outward bulging mass, which was centrally necrotic and contained hemorrhagic-necrotic material. On histo-pathological examination, features suggestive of gastrointestinal stromal tumor (GIST) with mixed spindle and epitheoid pattern was seen. Mitoses were slightly increased (<5 /> HPFs) leading to the conclusion of LOW GRADE GIST with tumor free margins of gut (R0 resection). So it was a case of Gastrointestinal stromal tumors (GIST), which is a rare medical presentation. So it was decided to report this case as a rare case presentation.
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Ulcerative disease of the stomach and duodenum
1.
PEPTIC ULCER
2.
3.
4.
5.
6.
7.
8.
9.
10.
SYMPTOM OF “Haudek's
niche”
11.
STENOSIS
12.
GASTROSCOPY
13.
DEVICE FOR GASTRIC
DOPPLEROGRAPHY
14.
Endoscopic picture of
the normal stomach wall
15.
Endoscopic picture of
the peptic ulcer
16.
17.
18.
Billroth I and
Billroth II resection
19.
Billroth II resection
20.
Billroth I resection:
21.
DUODENAL ULCER
22.
23.
24.
25.
26.
DUODENOSCOPY
27.
SYMPTOM OF “Haudek's
niche” STENOSIS
28.
29.
30.
31.
32.
TRUNK VAGOTOMY (TrV)
2 4
33.
3 SELECTIVE VAGOTOMY
( S V)
34.
SELECTIVE PROXIMAL VAGOTOMY
( SP V)
35.
SELECTIVE PROXIMAL VAGOTOMY
( SP V)
36.
Heineke-Mikulicz pyloroplasty
37.
Heineke-Mikulicz pyloroplasty
38.
GASTRODUODENOSTOMY BY JABOULAY
39.
Finney pyloroplasty
40.
41.
42.
ULCER
STENOSIS
43.
44.
45.
Perforated ulcer
(pneumoperitoneum)
46.
47.
48.
ENDOSCOPY
stopped bleeding
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