[Oncologic emergency in the abdomen].
Nobutaka Sato1, Naoko Hayashi, Yuu Imamura
1Dept. of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan.
Gan to Kagaku Ryoho. Cancer & Chemotherapy
|December 23, 2008
Summary
Cancer emergencies, like bleeding or obstruction, require prompt treatment. Advances have reduced their occurrence, but quick diagnosis and patient-specific care remain vital for managing these critical conditions.
Area of Science:
- Oncology
- Gastroenterology
- Interventional Radiology
Context:
- Abdominal oncologic emergencies, including hemorrhage, obstruction, and perforation, present critical challenges in cancer care.
- While advancements in diagnostics and therapeutics have decreased their incidence, these emergencies necessitate immediate and tailored interventions.
Purpose:
- To review the typical presentations and management strategies for abdominal oncologic emergencies.
- To emphasize the importance of prompt diagnosis and patient-specific treatment for conditions like gastrointestinal bleeding, obstruction, and perforation.
Summary:
- Hemorrhage management includes endoscopic hemostasis for gastrointestinal bleeding and transcatheter arterial embolization for hepatocellular carcinoma rupture.
- Obstruction management varies: upper-gastrointestinal requires prognosis consideration, while colorectal obstruction necessitates initial decompression.
- Colorectal perforation demands immediate surgery to prevent septic shock, and acute obstructive suppurative cholangitis requires endoscopic retrograde cholangiography.
Impact:
- Improved understanding of oncologic emergency management can lead to better patient outcomes.
- Highlights the ongoing need for vigilant diagnosis and rapid, individualized treatment protocols in oncology.
Related Concept Videos
01:27Peptic Ulcer
Peptic ulcers are erosive lesions of the gastric or duodenal lining, most commonly caused by Helicobacter pylori infection. This Gram-negative, helical bacterium has adapted to survive the stomach’s acidic environment by producing urease, which converts urea into ammonia and carbon dioxide. The ammonia neutralizes gastric acid in the bacterium’s immediate environment, allowing colonization of the gastric mucosa. H. pylori attaches to mucus-secreting epithelial cells, penetrates the mucus...
01:30Acute Pancreatitis II: Clinical Manifestations and Management
Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
01:25Acute Pancreatitis I: Introduction
Acute pancreatitis is the sudden inflammation of the pancreas caused by the early activation of digestive enzymes, leading to the autodigestion of pancreatic tissue. This results in local inflammation and, in severe cases, systemic complications.EtiologyUnderstanding the underlying causes is crucial, as identifying the etiology guides treatment and anticipates complications. Acute pancreatitis can be triggered by various factors, typically grouped into the following clinical categories.Biliary...
01:19Appendicitis
Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
01:07Intestinal Obstruction II: Pathophysiology
Intestinal obstruction triggers a series of physiological responses, starting with gas and fluid accumulation in the bowel segment proximal to the obstruction, leading to distension. This distended intestine compresses the diaphragm, hindering lung expansion and potentially leading to reduced respiratory effort, atelectasis, and pneumonia.To overcome the blockage, the gut intensifies contractions, causing colicky abdominal pain, nausea, and vomiting, which reduces fluid and food intake and...