Swelling of the legs with stomach cancer
Feverish form of stomach cancer is often encountered. In most cancer cases, the measurement of temperature allows us to detect, as a rule, subfebrile, but sometimes the temperature is sharply increased to 39 and 40 °. Cancer of the stomach can sometimes be mixed with malaria, "the widespread dissolution of medullary gastric cancer can give a picture similar to even typhoid fever. Sometimes expressed fever is the first manifestation of the disease.
Anemic form develops in cases of prolonged, usually hiddenbleeding; in some cases it is patients suffering from an anemia of Birmer, who developed stomach cancer. The edema of stomach cancer occurs with prolonged eating disorders, development of severe hypoproteinemia and anemia; swelling of the legs, puffiness of the face - in these cases, the most expressive symptom, and sometimes the first symptom that drew the attention of the patient.
The gastralgic form or "painful indigestion" arises from either germination or metastases in the nerve plexuses of the posterior abdominal wall, or represents a peptic ulcer of stomach cancer.
The greatest clinical interest areinitial forms of stomach cancer. They can be divided into three large groups: 1) latent forms, 2) painless forms and 3) with a pain syndrome that includes the primary ulcerative form of stomach cancer.
1. Latent forms of onset of gastric cancer represent the most dangerous and predictivesevere cases due to too late detection of the disease. These forms include cases of a completely hidden current, in which the first signs, for example bloody vomiting, are detected shortly before death, are opened by the doctor accidentally or during a dispensary examination in the form of a palpable tumor, or the radiographic defect of the filling of the stomach is determined radiographically. Sometimes a patient consults a doctor only "because he felt a swelling in his stomach."
Somewhat more often, hidden forms of stomach cancerare detected for the first time in the detection of metastases or symptoms caused by germination or distant metastases. Often, metastatic liver cancer is the first objective sign of stomach cancer, even more often the lymph node of the neck (Virchow's gland) is recognized before the discovery of gastric damage, sometimes the clinical onset of the disease is detected in the ovarian tumor (the Crockenberg tumor) or in the lesions of the bones in which the metastases are radologically established , edema or fistula gastrolitics open the disease in its last stage.
It should not be stressed that the latent form of stomach cancer can last 5 or even 8 years.
2. Bezbolovye forms of the onset of carcinoma of the stomach are the most frequent. Uncertainty of subjective symptoms and complaints of the patient often misleads the doctor in the absence of oncological alertness. Progressive loss of appetite, some weakness, easy fatigue, physical and intellectual, sometimes last for weeks before the patient consults a doctor. Along with the violation of appetite, sometimes the smoker has indifference to tobacco, then can join a slight nausea and heaviness in the epigastric area after eating. In some cases, "mild malaise" does not go away from the prescribed treatment (diet, rest, etc.), in other fairly common cases, treatment prescribed for "gastritis" gives relief, sometimes significant, and thus time is removed for the correct recognition and treatment. In some cases, the change in the patient's condition is noticed for the first time only by those around him - facial expression, some pallor, weight loss, etc. Disturbance of swallowing as the first manifestation of the disease is observed in the development of carcinoma near the cardiac region of the stomach; sometimes dysphagia is intermittent at first, and then becomes more and more stubborn.
Bleeding more or less in cancerstomach are a fairly common symptom, but in some cases, large gastric bleeding opens the onset of the disease. At the same time, the origin of the bleeding may remain unclear for some time. X-ray examination may give indeterminate symptoms with a small carcinoma in the region of the bottom or large curvature of the stomach; with this localization, bleeding may be the only symptom, while the lesion of small curvature or the prepiloric part of the stomach is usually accompanied by dyspepsia or pain. In other cases, the cause of bleeding is a cancer ulcer (radiographically manifested "niche"), which for some time can be considered benign.
When detecting hidden bleeding, and in the absence of bleeding, diagnosis can be for a long time uncertain or erroneous.
Stomach cancer, which begins with intestinal symptoms,is often encountered; complaints of constipation may accompany various gastric manifestations of the disease. Sometimes they dominate the picture of the disease; less frequent diarrhea. Severe diarrhea was the reason for going to the doctor in case of a gastrocolist fistula.
To the painless forms of onset of stomach cancer are cases of "unexplained" weight loss seen by the patient or others.
3. Painful forms of stomach cancer deserve a detailed description becauserelatively early "open" the disease. Pain forms include the primarily ulcerative form of stomach cancer. There are three types of malignant gastric ulcers:
1) ulcerated carcinomas, in which ulceration is secondary and occurs as a result of necrosis and the disintegration of a cancerous tumor,
2) the so-called cancer of an ulcer or cancerous transformation of a chronic benign ulcer of the stomach and, finally,
3) the primary ulcerative form of cancer, ie, a malignant lesion of the stomach, which from the very beginning develops as ulceration.
The characteristic morphological features of this form of stomach cancer are:
1) very early terms of ulceration,
2) flat and mostly rounded appearance of ulceration,
3) no tumor for a long time of illness.
If known forms of stomach cancer canfor a long time to flow secretly, without any indicative local and general clinical symptoms, or accompanied by a variety of not always distinct clinical manifestations, the primary ulcerative form of cancer, unlike other forms, has - with a few exceptions - a very definite clinical picture with a clear beginning, opening the disease in the early stages of its development
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