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[Gastric cancer 727 - AGC with obstruction]

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°í·É À§¾ÏÀ¸·Î obstruction Áõ»óÀÌ ÀÖ¾ú½À´Ï´Ù.

CT¿¡¼­ ´ÙÀ½°ú °°Àº ¼Ò°ßÀ̾úÀ¸³ª ÀÏ´Ü ¼ö¼úÀ» ½ÃµµÇØ º¸±â·Î ÇÏ¿´½À´Ï´Ù.

¡°StomachÀÇ pyloric canalÀ» involve ÇÏ´Â ¾à 4 cm Å©±âÀÇ concentric wall thickeningÀÇ mass lesionÀÌ ÀÖÀ½. ÁÖÀ§·Î mildÇÑ perigastric infiltrationÀÌ µ¿¹ÝµÇ¾î ÀÖÀ½. Duodenal bulb·Î ´Ù¼Ò bulgingÇÏ°í ÀÖ¾î duodenal bulb involvement °¡´É¼ºÀÌ ÀÖÀ½. Gastrocolic trunk ÁÖÀ§¿Í lesser omentum, common hepatic artery ÁÖÀ§ÀÇ metastatic lymph nodeµéÀÌ ÀÖ°í °¡Àå Å« º´º¯Àº ¾à 5 cmÀ¸·Î ÃøÁ¤µÇ¸ç pancreas head¿Í ¾à 2 cm¿¡ °ÉÃÄ attach µÇ¾î ÀÖÀ½.¡±

¼ö¼úÀå¿¡¼­ peritoneal seedingÀ̳ª distant metastasis ¼Ò°ßÀÌ ¾ø¾î¼­ curative surgery ½ÃµµÇßÀ¸³ª, pancreas head invasionÀÌ ¶Ñ·ÇÇÏ¿´°í, 12p, 13, 14v ¸²ÇÁÀý±îÁö ÀüÀÌµÈ »óÅÂÀÌ°í major vessel invasionµµ µ¿¹ÝµÇ¾î ÀÖ°í, bleedingµµ Áö¼ÓµÇ¾î radical gastrectomy´Â ºÒ°¡´ÉÇÏ¿© bypass GJ ¹Û¿¡ ÇÒ ¼ö ¾ø¾ú´Ù°í ÇÕ´Ï´Ù.

© ÀÏ¿ø³»½Ã°æ±³½Ç ¹Ù¸¥³»½Ã°æ¿¬±¸¼Ò ÀÌÁØÇà. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng. (2019-3-3)