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MANAGEMENT OF CANCER OF THE STOMACH IN MULAGO HOSPITAL KAMPALA, UGANDA
Abstract
Objective: To determine the cIinical presentation, mode of investigation and management of
gastric cancer at New Mulago Hospital.
Design: Prospective descriptive study.
Settings: Three general surgical wards, Department of Surgery, New Mdago Hospital.
Subjects: Thirty five patients were studied within 12 months.
Result: Gastric cancer was found to be prevalent in tribe inhabiting volcanic areas of south
western Uganda especially the Banyankole (25% 'c) The commonest mode of clinical
presentation was epigastric pain, weight loss, constipation, epigastric tenderness, palpable
+gastric mass and anaemia. The most accurate mode of investigation was by endoscopy
followed by barium meal. The cun~nbonest Imality was thepyloricatrium (40%) histologically
adenocarcinun~a (95.5 Tc) predominated. Gastric cancer was found to be more common in
patients with blood group O+ve. All patient* had been subjected to some kind of medical
treatment especially with at~tiacids, Hz receptor antagonists which contributed to the deIay
in presentation. The majority of patients (94.5%) presented with advanced disease and no
curative surgery was possible.
Conclusions: These results show that early diagnosis of gastric cancer is still a dream at
Mulago hospital since most patients present with advanced disease. To address this problem,
all health workersshauld besensitisedonsympbrnsrndsignsfor early aggressiveinvestigation
or an early referral tn cnable early diagnosis of gastric cancer. The investigatory capacity of
rural hospitals shouid be boosted to enable early detection of gastric cancer.
gastric cancer at New Mulago Hospital.
Design: Prospective descriptive study.
Settings: Three general surgical wards, Department of Surgery, New Mdago Hospital.
Subjects: Thirty five patients were studied within 12 months.
Result: Gastric cancer was found to be prevalent in tribe inhabiting volcanic areas of south
western Uganda especially the Banyankole (25% 'c) The commonest mode of clinical
presentation was epigastric pain, weight loss, constipation, epigastric tenderness, palpable
+gastric mass and anaemia. The most accurate mode of investigation was by endoscopy
followed by barium meal. The cun~nbonest Imality was thepyloricatrium (40%) histologically
adenocarcinun~a (95.5 Tc) predominated. Gastric cancer was found to be more common in
patients with blood group O+ve. All patient* had been subjected to some kind of medical
treatment especially with at~tiacids, Hz receptor antagonists which contributed to the deIay
in presentation. The majority of patients (94.5%) presented with advanced disease and no
curative surgery was possible.
Conclusions: These results show that early diagnosis of gastric cancer is still a dream at
Mulago hospital since most patients present with advanced disease. To address this problem,
all health workersshauld besensitisedonsympbrnsrndsignsfor early aggressiveinvestigation
or an early referral tn cnable early diagnosis of gastric cancer. The investigatory capacity of
rural hospitals shouid be boosted to enable early detection of gastric cancer.
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