A Rare Case Report of Gastric Adenocarcinoma with Pneumoperitoneum after Jejunostomy Feeding

Abstract

Background: Gastric cancer is the third highest cancer mortality globally. This malignancy can result in emergency complications such as gastric perforation which results in pneumo­peritoneum. Currently, there are not many case reports which describe pneumoperitoneum in gastric cancer. In this report, we describe a gastric adenocarcinoma with pneumoperitoneum following jejunostomy feeding.

Case Presentation: A 54 years old male presented with abdominal pain, black-colored feces, and body weight decrease as much as 22 kg within a month. The physical examination revealed anemic conjunctiva, distended abdomen with abdominal pain, and pale skin. On the lab examination, the hemoglobin level was 9.9 mg/dL. The peripheral blood smear showed signs of iron deficiency anemia caused by chronic process. An endoscopic examination and biopsy showed a gastric mass with well-moderately differentiated gastric adenocarcinoma. The three positions abdominal x-ray incidentally found that the patient had pneumoperitoneum.

Results: Patient was diagnosed with Adenocarcinoma Gaster based on a gastric mass biopsy with hematoxylin-eosin staining. Then, the patient was treated with jejunostomy feeding. Thoracic and 3-position abdominal X-ray examinations revealed incidental findings of pneumoperitoneum and small bowel obstruction.

Conclusion: Jejunostomy feeding in gastric cancer patient may result in pneumoperitoneum as a complication. Gastric adenocarcinoma followed by iron deficiency anemia from chronic process post jejunostomy feeding was found with pneumoperitoneum complication.