Abstract
We report one case of a rare perforative early gastric cancer. A 63-year-old man had been suffering from left hypochondralgia since mid-December 2005 and had been taking an anodyne. The left hypochondralgia had become stronger a few days after, and the patient came our hospital emergency room at night. An emergency operation was performed under a diagnosis of peritonitis due to upper gastrointestinal perforation. A 5 mm perforation was observed on the anterior wall of the angle of the stomach, and the stomach was swollen as if there was a tumor inside. Because there was no denying that the perforation was due to gastric cancer, a distal gastrectomy with Dl+No.7, 8a lymph node dissection was performed. Histopathological examination showed that early gastric cancer (III+IIc, sm) had perforated and No.3, 4d, 5, 6, 7, 8a lymph nodes were metastatic lymph nodes. The patient is currently taking oral S-1 and undergoing drip infusion CDDP for adjuvant chemotherapy.
