Patient complaints of pain abdomen and multiple episodes of vomitting. Patient gave history of significant weight loss. Patient only had undergone few investigations (reports attached) . Pls discuss how to investigate and manage this case

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1.ogd scopy...gastric mucosa biopsy. 2. CT guided biopsy Lymph node. 3. chemo as per HPE. 4. if Ca stomoch....total gastrectomy

Then chemo
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blood transfusion and iv fluid... inj ondadteron... inj pantoprazole .... inj optineuron... repeat FBS and BSPP..... plan for surgery

first biopsy confirmation should be done followed by metastatic workup in the form of chest x ray or ct chest if biopsy came out as malignancy. if it is adenocarcinoma, perioperative chemotherapy or initial surgery followed by adjuvant chemoradiation should be given

first UGIE and biopsy and rest according to report of boipsy

ca stomach.stage iv . confirm biopsy as malignancy. adeno ca. stabilise the patient . repeat cect abdomen and chest . if signs of obstructions , stabilise. plan is Palliative chemo therapy

What is the biopsy report?If it's adenocarcinoma stomach,then neoadjuvent chemotherapy with cis-platin,fluorouracil regimen followed by surgery depending on the response to chemotherapy. If it's lymphoma,then radiotherapy can be of help.

Obviously patient should be stabilized first.Gastric stent can be applied in the mean-time as palliative measure or nasojejunal tube can be applied for nutrition.
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Dear Dr plz take a biopsy and also send ESR CT ABDOMEN (P+C) PROPERLY 1.POSSIBILITY OF NEOPLASTIC GROWTH 2.IT MAY ALSO ABDOMINAL KOCH 3.IN ACUTE INFECTION CAN CAUSE A MESSENTRIC LYMPHANDENOPATHY

yes u are right
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Get upper GI Scopy with biopsy done.If the pt s tolerating oral feeds start neoadjuvant chemotherapy

case of pancreatitis

in that case enzyme lipase should elevated here it is normal
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