1991 Volume 41 Issue 2 Pages 345-351
From January 1984 to August 1990, 5 cases of perforated gastric cancer were treated in Tano General Hospital. We compared these cases clinicopathologically with 72 cases reported recently in Japan.
1) 18.5% of cases of upper gastrointestinal perforation were due to perforated gastric cancer.
2) Statistically, the male/female ratio is reported as being 2 to 1, but our cases were all male.
3) The main symptom was nonspecific abdominal pain, and only 27% of 59 cases were accurately diagnosed before operation.
4) One fourth of 51 cases had prior examination such as fibrescopy and barium roentgenogram.
5) The macroscopic types of the perforated cancers (64 cases) were Borrmann 2 (17), 3 (32), 4 (6), and early cancer (9).
6) The sites of perforation were mainly on the anterior wall of the corpus (24), the antrum (20), and on the lesser curvature of the antrum (8).
7) There was no difference in frequency of perforation between histologically differentiated and undifferentiated tumors.
8) At operation, the cancer was liable to be judged more advanced than on histological staging.
9) 10 cases out of 59 survived more than three years. The incidence of death within a month after operation was very high at 25.4%, due to cases being far advanced, and patients being elderly compared with those with peptic ulcer.
