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• W2033269056 abstract "Dr. McFarland. A 68-year-old woman was admitted to the gynecologic oncology service because of increasing abdominal girth, nausea, and abdominal pain. Eight months ago she had undergone an abdominal hysterectomy and bilateral saipingo-oophorectomy, pelvic lymph node dissection, and omental biopsy and had been found to have grade Il-Ill, stage lB papillary serous adenocarcinoma of the endometrium. She had received no adjuvant chemotherapy. On admission, she had ascites shown by clinical examination and CT, along with diffuse omental disease (Fig. 1A). Serum albumin level was low, at 2.4 g/dI (normal range, 3.14.3 g/dI). The level of carcinoembryonic antigen was elevated, at 432 .tg/mI (reference range, 0-35 ig/ml). Sonographically guided abdominal paracentesis yielded 3.5 I of fluid. Adenocarcinoma was detected on cytologic examination of this fluid. These findings were all consistent with recurrent endometrial carcinoma. Adjuvant chemotherapy was started. A nasogastric tube was passed due to recurrent emesis of approximately 200-400 mI/day. A week later, the patient remained nauseated with nasogastric output approximating 400 mI/day. Her abdominal girth had again increased and a further 5 I of ascitic fluid was removed under sonographic guidance. The serum albumin level had dropped to 1 .8 g/dI. A Hickman catheter was inserted surgically 2 weeks after admission, after which total parenteral nutrition was begun. Two days later, her abdominal girth had again increased and she continued to complain of nausea and retching. Nasogastric output continued at 250-400 mI/day. An upper gastrointestinal series and follow-through showed severe gastroesophageal reflux, but further evaluation of the small bowel was not possible as the patient could not tolerate further barium, despite injection through the nasogastric tube. It was decided that a percutaneous gastrojejunostomy should be done for long-term drainage of the small bowel." @default.
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• W2033269056 date "1995-01-01" @default.
• W2033269056 modified "2023-10-14" @default.
• W2033269056 title "Gastropexy breakdown and peritonitis after percutaneous gastrojejunostomy in a patient with ascites." @default.
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• W2033269056 doi "https://doi.org/10.2214/ajr.164.1.7998537" @default.
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