GI Malignancy Flashcards
What are the symptoms of upper GI malignancy
Dysphagia
Epigastric pain - malignancy suggestive if patient has epigastric pain as well as melaena or haematemesis
Jaundice
What red flags are there that along with dysphagia suggest malignancy
Anaemia
Loss of weight
Anorexia
Recent onset of progressive symptoms
Masses/malaena
What red flags are there that along with jaundice that suggest malignancy
Hepatomeglay with an irregular border
Unintentional weight loss
Ascities - exudate in malignant causes, transudate in non-malignant
Painless jaundice
Describe oesophageal tumors
Oesophageal tumours are mostly carcinomas but can be adenocarinoma if develop from Barrett’s
Typically present with progressive dysphagia but if presenting with symptoms, likely has metastasised
Risk factors include smoking and Barrett’s
Describe gastric cancers
Are adenocarcinomas and typically occurs in antrum or cardia
If gastric cancer occurs near oesophageus can have dysphagia
If gastric cancer occurs near duodenum can have vomiting
Present with pain similar to peptic ulcer and 50% have palpable mass
Risk factors: high salt diet, smoking, family history, H. pylori
Name some other cancers that can occur in the stomach (not gastric)
Gastric lymphoma - MALT tissue
Gastrointestinal stromal tumours - sarcomas that tend to be benign but can be malignant
Name some cancers other than gastric and oesophageal that can occur in the GI system (not intestines)
Liver malignancies - hepatocellular carcinomas can occur though are rare
Bile duct cancer - cholangiocarcioma. PSC increases risk
Pancreatic cancer - 80% are ductal adenocarcinomas. Poor prognosis as usually advanced on diagnosis. Have jaundice if malignancy occurs in the head while if it occurs in the body/tail have more vague symptoms. Can affect endocrine/exocrine function. Risk factors: family history, smoking, age, male, chronic pancreatitis
What are the symptoms of lower GI malignancy
Obstruction
PR bleeding
Change in bowel habits
Describe how obstruction presents and what different obstructions cause
Obstruction presents with abdominal distension and abdominal pain
Obstruction in small bowel causes vomiting/nausea
Obstruction in large bowl causes constipation
What are red flags of obstruction
Unintentional weight loss
Unexplained abdominal pain that cannot be attributed to anything on examination
What are the red flags of PR bleeding
Age dependent - younger patients less likely to have malignancy
Iron deficient anaemia
Change in bowel habits
Unexplained weight loss
Tenesmus
What are the symptoms of a change in bowel habits
Changes in frequency
Change in consistency
Associated conditions like bloating and abdominal discomfort
What are the red flags that accompany a change in bowel habits
Age dependent
Iron deficient anaemia
Unexplained weight loss
PR blood loss
What are some benign causes of obstruction
Volvulus
Diverticular disease
Hernia
What are some benign causes of PR bleeding
Haemorrhoids
Anal fissure
Infective gastroenteritis
IBD
Diverticular disease
Upper GI bleed - oesophageal varices, acute gastritis, peptic ulcer
