{"id":80920,"date":"2025-05-06T16:11:56","date_gmt":"2025-05-06T14:11:56","guid":{"rendered":"https:\/\/www.revista-portalesmedicos.com\/revista-medica\/?p=80920"},"modified":"2025-05-04T08:56:57","modified_gmt":"2025-05-04T06:56:57","slug":"adenocarcinoma-gastrico-avanzado-con-complicacion-de-obstruccion-intestinal","status":"publish","type":"post","link":"https:\/\/www.revista-portalesmedicos.com\/revista-medica\/adenocarcinoma-gastrico-avanzado-con-complicacion-de-obstruccion-intestinal\/","title":{"rendered":"Adenocarcinoma g\u00e1strico avanzado con complicaci\u00f3n de obstrucci\u00f3n intestinal"},"content":{"rendered":"

Adenocarcinoma g\u00e1strico avanzado con complicaci\u00f3n de obstrucci\u00f3n intestinal<\/strong><\/p>\n

Autora principal:<\/strong> Lorena Dom\u00ednguez Cuevas<\/p>\n

Vol. XX; n\u00ba 09; 423<\/p>\n

Advanced gastric adenocarcinoma with bowel obstruction complication<\/strong><\/p>\n

Fecha de recepci\u00f3n:<\/strong> 19 de febrero de 2025
\nFecha de aceptaci\u00f3n:<\/strong> 30 de abril de 2025<\/p>\n

Incluido en Revista Electr\u00f3nica de PortalesMedicos.com Volumen XX. N\u00famero 09 Primera quincena de mayo de 2025 \u2013 P\u00e1gina inicial: Vol. XX; n\u00ba 09; 423<\/p>\n

\u00a0<\/strong><\/p>\n

Autores: <\/strong>Lorena Dom\u00ednguez Cuevas; Alba Cirac Oriol; Pedro Roberto Sancho Ortega; Mar\u00eda Ester Cano Serrano; Sheila Larrayad Sanz; Angie Yurani Ramos de los R\u00edos; Roc\u00edo del Pilar P\u00e9rez Orozco.<\/p>\n

Centro de Trabajo actual: <\/strong>Hospital Cl\u00ednico Universitario \u201cLozano Blesa\u201d de Zaragoza (Espa\u00f1a)<\/p>\n

Palabras clave en espa\u00f1ol: <\/strong>adenocarcinoma, g\u00e1strico, obstrucci\u00f3n, intestinal, cirug\u00eda.<\/p>\n

Palabras clave en ingl\u00e9s: <\/strong>adenocarcinoma, gastric, obstruction, intestinal, surgery.<\/p>\n

Resumen en espa\u00f1ol:<\/strong><\/p>\n

Se presenta el caso de un paciente masculino de 70 a\u00f1os diagnosticado con adenocarcinoma g\u00e1strico avanzado, que consulta por dolor abdominal persistente, v\u00f3mitos y distensi\u00f3n abdominal. En los estudios de imagen, se observ\u00f3 una masa en el est\u00f3mago y signos de obstrucci\u00f3n intestinal distal. La biopsia confirm\u00f3 adenocarcinoma g\u00e1strico. Debido a la obstrucci\u00f3n intestinal y la extensi\u00f3n de la enfermedad, el paciente fue manejado inicialmente con medidas paliativas, incluyendo la colocaci\u00f3n de una pr\u00f3tesis g\u00e1strica para aliviar la obstrucci\u00f3n. La quimioterapia fue indicada para controlar la progresi\u00f3n de la enfermedad. Dado el pron\u00f3stico reservado debido al estadio avanzado y las complicaciones, el enfoque terap\u00e9utico se centr\u00f3 en mejorar la calidad de vida.<\/p>\n

 <\/p>\n

Resumen en ingl\u00e9s: <\/strong><\/p>\n

We present the case of a 70-year-old male patient diagnosed with advanced gastric adenocarcinoma, who consulted for persistent abdominal pain, vomiting and abdominal distension. Imaging studies showed a mass in the stomach and signs of distal intestinal obstruction. Biopsy confirmed gastric adenocarcinoma. Due to the intestinal obstruction and extent of the disease, the patient was initially managed with palliative measures, including placement of a gastric prosthesis to relieve the obstruction. Chemotherapy was indicated to control disease progression. Given the guarded prognosis due to the advanced stage and complications, the therapeutic approach focused on improving quality of life.<\/p>\n

 <\/p>\n

Los autores de este manuscrito declaran que:<\/p>\n

Todos ellos han participado en su elaboraci\u00f3n y no tienen conflictos de intereses
\nLa investigaci\u00f3n se ha realizado siguiendo las Pautas \u00e9ticas internacionales para la investigaci\u00f3n relacionada con la salud con seres humanos elaboradas por el Consejo de Organizaciones Internacionales de las Ciencias M\u00e9dicas (CIOMS) en colaboraci\u00f3n con la Organizaci\u00f3n Mundial de la Salud (OMS).
\nEl manuscrito es original y no contiene plagio.
\nEl manuscrito no ha sido publicado en ning\u00fan medio y no est\u00e1 en proceso de revisi\u00f3n en otra revista.
\nHan obtenido los permisos necesarios para las im\u00e1genes y gr\u00e1ficos utilizados.
\nHan preservado las identidades de los pacientes.<\/p>\n

 <\/p>\n

Caso Cl\u00ednico:<\/strong><\/p>\n

 <\/p>\n

Motivo de consulta<\/strong>:
\nPaciente masculino de 70 a\u00f1os, con antecedentes de hipertensi\u00f3n y diabetes tipo 2 controlada, que se presenta en la consulta por dolor abdominal persistente, v\u00f3mitos frecuentes y distensi\u00f3n abdominal progresiva durante las \u00faltimas tres semanas. Refiere p\u00e9rdida de peso significativa de aproximadamente 8 kg en el \u00faltimo mes.<\/p>\n

 <\/p>\n

Historia cl\u00ednica<\/strong>:
\nEl paciente tiene antecedentes de consumo de alcohol ocasional y tabaquismo hasta hace 10 a\u00f1os. Niega antecedentes familiares de c\u00e1ncer. En la exploraci\u00f3n f\u00edsica, se observa distensi\u00f3n abdominal generalizada, con ruidos intestinales disminuidos y dolor a la palpaci\u00f3n en la regi\u00f3n epig\u00e1strica. Se realizaron ex\u00e1menes de laboratorio, que mostraron anemia leve.<\/p>\n

 <\/p>\n

Pruebas diagn\u00f3sticas<\/strong>:
\nSe solicit\u00f3 una tomograf\u00eda computarizada (TC) de abdomen y pelvis, que mostr\u00f3 una masa en el est\u00f3mago de aproximadamente 5 cm, adem\u00e1s de signos de obstrucci\u00f3n intestinal distal y dilataci\u00f3n de las asas intestinales. La endoscopia g\u00e1strica revel\u00f3 una lesi\u00f3n ulcerada en la curvatura mayor del est\u00f3mago, compatible con adenocarcinoma g\u00e1strico. La biopsia confirm\u00f3 la presencia de adenocarcinoma g\u00e1strico. No se observaron met\u00e1stasis a distancia en los estudios de imagen.<\/p>\n

 <\/p>\n

Tratamiento<\/strong>:
\nDebido al estadio avanzado y la presencia de obstrucci\u00f3n intestinal, se opt\u00f3 por un manejo paliativo. Se realiz\u00f3 la colocaci\u00f3n de una pr\u00f3tesis g\u00e1strica para aliviar la obstrucci\u00f3n y mejorar el paso de los alimentos. Adem\u00e1s, se inici\u00f3 quimioterapia con un r\u00e9gimen basado en 5-fluorouracilo y oxaliplatino. El paciente fue monitorizado estrechamente por posibles complicaciones como n\u00e1useas, v\u00f3mitos y desnutrici\u00f3n.<\/p>\n

 <\/p>\n

Pron\u00f3stico<\/strong>:
\nEl pron\u00f3stico es reservado debido a la extensi\u00f3n avanzada de la enfermedad y la complicaci\u00f3n de la obstrucci\u00f3n intestinal. Aunque la colocaci\u00f3n de la pr\u00f3tesis g\u00e1strica ha aliviado la obstrucci\u00f3n, el manejo se centr\u00f3 en el control sintom\u00e1tico y la mejora de la calidad de vida. La esperanza de vida se limita a meses, dependiendo de la respuesta a la quimioterapia.<\/p>\n

 <\/p>\n

Seguimiento<\/strong>:
\nEl paciente fue seguido mensualmente en consulta externa para evaluar la respuesta a la quimioterapia y monitorear el estado general. Se realizaron controles regulares de los niveles de hemoglobina y funci\u00f3n renal, y se ajustaron los tratamientos seg\u00fan la tolerancia. Adem\u00e1s, se proporcion\u00f3 soporte nutricional y manejo del dolor.<\/p>\n

 <\/p>\n

Discusi\u00f3n<\/strong>:
\nEl adenocarcinoma g\u00e1strico avanzado es una enfermedad de mal pron\u00f3stico debido a su tendencia a presentarse en etapas avanzadas, donde las opciones terap\u00e9uticas curativas son limitadas. La obstrucci\u00f3n intestinal es una complicaci\u00f3n com\u00fan en los c\u00e1nceres g\u00e1stricos avanzados y se maneja de forma paliativa, generalmente con la colocaci\u00f3n de una pr\u00f3tesis para aliviar la obstrucci\u00f3n. El tratamiento est\u00e1ndar para el c\u00e1ncer g\u00e1strico avanzado incluye la quimioterapia, pero la respuesta puede ser variable. El manejo multidisciplinario es crucial para mejorar la calidad de vida de los pacientes y controlar las complicaciones. La supervivencia depende de la respuesta al tratamiento y la presencia de met\u00e1stasis en otros \u00f3rganos.<\/p>\n

\u00a0<\/strong><\/p>\n

Bibliograf\u00eda: <\/strong><\/p>\n

\u00a0<\/strong><\/p>\n

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