Diagnostic and Therapeutic Approach to Pancreatic Cancer-Associated Gastroparesis

Leung, John; Silverman, William B.

doi:10.1007/s10620-008-0354-3

Cited by 13 publications

(6 citation statements)

References 21 publications

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“…50 Delayed gastric emptying is also observed in 60% of patients with pancreatic carcinoma and to a lesser degree in patients with other malignancies (for example gastric, gallbladder, esophageal and lung cancer, and leiomyosarcoma). 51 Mechanisms of cancer associated gastroparesis include malignant infiltration of the vagus or autonomic nerves and autoantibody mediated myenteric damage. Ischemic gastroparesis results from celiac arterial thrombosis.…”

Section: Idiopathic Gastroparesismentioning

confidence: 99%

Gastroparesis: pathogenesis, diagnosis and management

Hasler

2011

Nat Rev Gastroenterol Hepatol

101

110

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Gastroparesis is a prevalent condition that produces symptoms of delayed gastric emptying in the absence of physical blockage. The most common etiologies of gastroparesis are idiopathic, diabetic, and postsurgical disease, although some cases stem from autoimmune, paraneoplastic, neurologic or other conditions. Histologic examination of gastric tissues from patients with severe gastroparesis reveals heterogeneous and inconsistent defects in the morphology of enteric neurons, smooth muscle and interstitial cells of Cajal, and increased levels of inflammatory cells. Diagnosis is most commonly made by gastric emptying scintigraphy; however, wireless motility capsules and nonradioactive isotope breath tests have also been validated. A range of treatments have been used for gastroparesis including dietary modifications and nutritional supplements, gastric motor stimulatory or antiemetic medications, endoscopic or surgical procedures, and psychological interventions. Most treatments have not been subjected to controlled testing in patients with gastroparesis. The natural history of this condition is poorly understood. Active ongoing research is providing important insights into the pathogenesis, diagnosis, treatment and outcomes of this disease.

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Section: Idiopathic Gastroparesismentioning

confidence: 99%

Gastroparesis: pathogenesis, diagnosis and management

Hasler

2011

Nat Rev Gastroenterol Hepatol

101

110

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“…11 , 12 Pancreatic cancer associated gastroparesis is a well-described condition that occurs in the absence of mechanical obstruction. 13 Large and obvious pancreatic masses may obstruct the duodenum and common bile duct, but pancreatic masses were not appreciated in 2 CTs in our patient, and pancreatic cancer was only diagnosed after Whipple procedure. The small pancreatic primary cancer directly invaded the duodenum and caused the obstructive gastroparesis, an unusual cause of gastroparesis.…”

Section: Discussionmentioning

confidence: 55%

Pancreatic Adenocarcinoma Invading the Duodenum and Presenting as Idiopathic Gastroparesis with Nausea and Vomiting

Cengia

Stuart

Koch

2016

ACG Case Reports Journal

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A 65-year-old woman presented with a 5-month history of nausea, vomiting, and weight loss. Prior esophagogastrodudenoscopy showed retained food and delayed gastric emptying, but abdominal computed tomography was normal. The working diagnosis was idiopathic gastroparesis. Subsequently, an electrogastrogram test showed normal 3-cycle-per-minute activity, although it was suggestive of obstructive gastroparesis. Repeat esophagogastrodudenoscopy showed obstruction at the postbulbar duodenum. Repeat abdominal computed tomography revealed a 2.2 x 1.6-cm mass in the pancreaticoduodenal groove narrowing the descending duodenum and aspiration of the mass revealed adenocarcinoma.

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“…In autonomic neuropathy, patients present with hypothermia, hypoventilation, sleep apnoea, intestinal pseudo-obstruction, gastroparesis, and cardiac arrhythmias with gastroparesis to be present in up to 60% of those who have gastrointestinal symptoms and suffer from cancer [12]. …”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Paraneoplastic Syndrome Presented with Severe Gastroparesis due to Ganglional Loss

Argyriou

Peters

Ishtiaq

et al. 2012

Case Reports in Medicine

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Paraneoplastic syndromes are rare initial manifestations of a neoplastic disorder that may precede the actual detection of an overt cancer. These syndromes can generally involve any organic system of the human body with gastroparesis being the commonest manifestation of the paraneoplastic involvement of the neuronal bodies of the gastrointestinal tract in cancer patients. Gastroparesis is the result of an autoimmune destruction of the nerve plexus of the stomach that causes nonspecific gastrointestinal symptoms such as intractable vomiting and abdominal discomfort that interfere with patients' quality of life and are often ascribed to psychological factors. Thus, if not suspected, it easily evades the diagnostic thought especially in those cases where the diagnostic work up has not detected any apparent cause. Consequently, it should always be considered in patients with diagnosed or suspected cancer who complain of unexplained gastrointestinal symptoms. In our report, so as to increase the clinical awareness of this rare clinical entity, we present the case of a 70-year-old Caucasian female who presented in our hospital with severe gastroparesis that was later proven to be associated with an overt small cell lung cancer (SCLC) and we discuss the existing knowledge of the pathophysiology, diagnosis, and management of this disorder.

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Diagnostic and Therapeutic Approach to Pancreatic Cancer-Associated Gastroparesis

Abstract: We propose a time-effective and useful strategy for diagnosing and managing patients with PCAG. We also define the diagnostic end-point for this difficult to manage condition.

Cited by 13 publications

References 21 publications

Gastroparesis: pathogenesis, diagnosis and management

Gastroparesis: pathogenesis, diagnosis and management

Pancreatic Adenocarcinoma Invading the Duodenum and Presenting as Idiopathic Gastroparesis with Nausea and Vomiting

A Rare Case of Paraneoplastic Syndrome Presented with Severe Gastroparesis due to Ganglional Loss

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