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Case Reports
. 2024 Nov 17;16(11):e73869.
doi: 10.7759/cureus.73869. eCollection 2024 Nov.

Gastric Carcinomas and Point-of-Care Ultrasound (POCUS): A Report of Two Cases

Vui H Chong  1
Affiliations
Case Reports

Gastric Carcinomas and Point-of-Care Ultrasound (POCUS): A Report of Two Cases

Vui H Chong. Cureus. .

Abstract

Stomach cancer remains a significant cause of mortality, as most patients are diagnosed at advanced stages. The primary method for diagnosis is endoscopy, along with tissue acquisition, supplemented by endoscopic ultrasound or computed tomography for disease staging. While point-of-care ultrasound (POCUS) is now firmly integrated into clinical practice, it is still not widely utilized. POCUS can be performed at the initial point of contact and provides instant information that can influence investigation strategies. We report two cases of gastric antral carcinoma detected by POCUS, which led to targeted investigations. Both patients underwent expedited upper gastrointestinal endoscopies that confirmed distal gastric carcinoma. These cases highlight the important role of POCUS in triaging patients for timely and appropriate targeted organ investigations.

Keywords: gastric neoplasm; point-of-care-ultrasound; stomach cancer; trans-abdominal ultrasound; ultrasound diagnosis.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Transverse POCUS images (4.5 MHz) of the epigastrium; a) showing thickened gastric antrum (A) due to the tumor extending to the pylorus (Py) with outer border having an irregular margin indicated by arrowheads located anterior to the pancreas (*), and b) showing the tumor affecting the antrum and pylorus.
POCUS: point-of-care ultrasound, A: antrum, Py: pylorus, SMA: superior mesenteric artery.
Figure 2
Figure 2. POCUS with a linear probe (8.5 MHz) showing mucosal layer with irregular posterior outer border (arrowheads) and compromised lumen (white arrow).
POCUS: point-of-care ultrasound, A: antrum.
Figure 3
Figure 3. Endoscopic image showing the stenosing gastric tumor located at the antrum.
Figure 4
Figure 4. Contrast enhanced CT scan showing thickened gastric antrum anterior and posterior walls (arrows).
CT: Computed tomography
Figure 5
Figure 5. An contrast enhanced axial CT images showing thickened antrum affecting the anterior wall (arrows).
CT: computed tomography
Figure 6
Figure 6. Bedside POCUS showing thickened antrum - a) distal antrum (A) with narrowing of the gastric lumen (L) and b) more proximal antrum without lumen compromise. There is varying wall thickness measuring 8.6 mm at the tumor area and 3.0 mm at the normal part of the stomach.
POCUS: point-of-care ultrasound, A: antrum, L: gastric lumen.
See this image and copyright information in PMC

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