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Open Access Case report

Adhesions due to peritoneal carcinomatosis caused by a renal carcinoma leading to mechanical gastric outlet obstruction: a case report

Filippo Mocciaro1*, Gabriele Curcio1, Ilaria Tarantino1, Luca Barresi1, Gaetano Burgio2, Salvatore Gruttadauria3, Settimo Caruso4 and Mario Traina1

Author Affiliations

1 Gastroenterology Unit, IsMeTT, UPMC, Via Tricomi 1, Palermo 90100, Italy

2 Intensive Care Unit, IsMeTT, UPMC, Via Tricomi 1, Palermo 90100, Italy

3 Surgery Unit, IsMeTT, UPMC, Via Tricomi 1, Palermo 90100, Italy

4 Radiology Unit, IsMeTT, UPMC, Via Tricomi 1, Palermo 90100, Italy

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Journal of Medical Case Reports 2011, 5:306  doi:10.1186/1752-1947-5-306

Published: 13 July 2011

Abstract

Introduction

Gastric outlet obstruction is a clinical syndrome caused by a variety of mechanical obstructions. Peptic ulcer disease used to be responsible for most gastric outlet obstruction, but in the last 40 years the prevalence of malignant tumors has risen significantly. Adhesive disease is an infrequent and insidious cause of mechanical gastric outlet obstruction.

Case presentation

We report the case of a 78-year-old Caucasian man who had a clinical history of a right nephrectomy for malignancy three years earlier and who was admitted for a severe gastric outlet obstruction (score of 1) confirmed both by an upper endoscopy and by a fluoroscopic view after contrast injection. A computed tomography scan and a laparotomy, with omental biopsies, showed a peritoneal carcinomatosis with the development of abdominal adhesions that prompted an abnormal gastric rotation around the perpendicular axis of his antrum with a dislocation in the empty space of his right kidney. Symptoms disappeared after surgical bypass through a gastrojejunostomy.

Conclusions

Our patient experienced a very rare complication characterized by the development of adhesions due to peritoneal carcinomatosis caused by a renal carcinoma treated with nephrectomy. These adhesions prompted an abnormal dislocation of his antrum, as an internal hernia, in the empty space of his right kidney.