[A study on cancers in the gastric remnant -from standpoint of radiology (author's transl)].

A radiologic study was done retrospectively of 51 cases with carcinoma of the gastric remnant. In each case, the gastric remnant was resected in Cancer Institute Hospital from January 1952 to December 1978, 1) Descriptive breakdown of the cases: a. 8 cases had benign lesions at the initial gastrectomy. b. 13 cases were found to have recurrent of cancer in the stump or metastasis. c. 16 cases had multiple cancerous lesions. d. 2 cases showed cancer in the reconstructed stomach after excision of esophageal carcinomas. 3. 12 cases had uncertain background information. 2) Chief complaints: Four out of the six cases of early cancer were asymptomatic. In the advanced carcinomas, 22 cases (60%) complained of dysphagia. 3) Period of time until re-resection and periodic examination: The period of time from the initial gastric resection until re-resection was less than 5 years in 22 cases (45%) and greater than 5 years in 29 cases (57%). Thus, periodic examinations employing both x-ray and endoscopy are very important even after 5 years have elapsed since gastrectomy. 4) Radiologic examination of gastric remnant carcinomas: After gastrectomy, particularly in the early period, careful attention should be paid to hyperplastic or granulomatous changes located at the suture line of the lesser curvature and the anastomosis. The sites of remnant carcinomas were found most frequently along the sutured portion of the lesser curvature or the anterior and posterior parts of the gastric remnant in 11 cases (27.5%). Seven cases (17.5%) were found in the cardia and five cases (12.5%) in the anastomosed portion. Therefore, it is very important to perform double contrast radiographs from the left anterior oblique projection which is close to the right lie projection, and to take pictures of the sites from the lower esophagus to the cardia of the stomach.