[Gastric adenocarcinoma following "silastic vertical ring gastroplasty": case report]

OBJECTIVES

Bariatric surgery is considered as the most effective therapy for morbid obesity. But, each procedure carries both short-and long-term complications. And, it remains unclear if the late occurrence of gastric adenocarcinoma could be linked to bariatric surgery. We described a case of a female who developed a gastric adenocarcinoma after a silastic ring vertical gastroplasty (SRVG).

METHODS

A 54-year-old female presented with postprandial vomiting, poor appetite, dysphagia and weight loss 10 year after a SRVG. A gastroscopy with biopsy disclosed a juxta-pyloric adenocarcinoma. No distant metastasis was found. After 3 cycles of neoadjuvant chemotherapy, a subtotal gastrectomy with Roux-en-Y anastomosis was performed.

RESULTS

After the surgery, a minor anastomotic leak was treated conservatively and a parietal abscess was drained. The pathological studies demonstrated a T2bN1 adenocarcinoma with negative margins. Adjuvant chemotherapy was administered. At the last work up, the patient is disease-free.

CONCLUSION

The association between a gastric adenocarcinoma and a bariatric procedure such as a SRVG is difficult to assess without a case-control or a cross-sectional study. Nevertheless, when new upper digestive tract complaints occur in any patient with an otherwise unremarkable bariatric surgery follow-up, the diagnosis of gastric cancer should be bear in mind.

Cholecystitis associated with heterotopic pancreas

Heterotopic pancreas is a rare developmental anomaly usually reported as an incidental finding. We describe a 1 cm diameter gallbladder heterotopic pancreas identified at pathological study. The patient, a 23-year-old woman, was suffering from cholecystitis. She underwent cholecystectomy with an uneventful course.