Blumer's Shelf on Laparoscopy

Abstract

Blumer's shelf indicates metastatic tumor deposit in rectouterine, or rectovesical pouch on digital rectal or vaginal examination, frequently from stomach, pancreatic, colon, or lung cancer. It underscores the need to carry out a thorough clinical examination. Though it is much discussed and described in the literature, there are hardly any article or image about its appearance on laparoscopy. We describe a case of gastric cancer with Blumer's shelf and its appearance on laparoscopy with clinical and radiological correlation.

Keywords: Blumer’s shelf; Gastric cancer; Laparoscopy.

Fig. 1

Poorly differentiated adenocarcinoma of stomach showing sheets of neoplastic cells without proper gland formation

Fig. 2

A CT cuts of pelvis showing deposit in rectovesical pouch. B Large infiltrative tumor in stomach along lesser curvature with multiple nodes in lesser omentum at laparoscopy. C Intraoperative laparoscopic picture showing multiple peritoneal deposits in pelvis. D Close-up laparoscopic view of pelvis showing large infiltrative deposit in rectovesical pouch