Clinical Presentation

Patients with gastroduodenal disease may be asymptomatic or experience one or more of the following: upper abdominal (epigastric) pain, dyspepsia ("indigestion"), vomiting which may be projectile if there is pyloric outflow obstruction, haematemesis (vomiting blood), melaena (altered blood per rectum) or dysphagia if there is a proximal gastric lesion.

Figure 2.2. Stomach: Regional lymph nodes. The regional lymph nodes are the perigrastric nodes along the lesser (1,3, 5) and greater (2,4a, 4b, 6) curvatures, the nodes located along the left gastric (7), common hepatic (S), splenic (10,11) and coeliac arteries (9) and the hepatoduodenal nodes (12). Involvement of other intra-abdominal lymph nodes such as the retropancreatic, mesenteric and para-aortic is classified as distant metastasis. Reproduced from Hermanek P, Hutter RVP, Sobin LH, Wagner G, Wittekind Ch (eds.). TNM atlas: illustrated guide to the TNM/pTNM classification of malignant tumours, 4th edition. Springer-Verlag: Berlin and Heidelberg, 1997.

Figure 2.2. Stomach: Regional lymph nodes. The regional lymph nodes are the perigrastric nodes along the lesser (1,3, 5) and greater (2,4a, 4b, 6) curvatures, the nodes located along the left gastric (7), common hepatic (S), splenic (10,11) and coeliac arteries (9) and the hepatoduodenal nodes (12). Involvement of other intra-abdominal lymph nodes such as the retropancreatic, mesenteric and para-aortic is classified as distant metastasis. Reproduced from Hermanek P, Hutter RVP, Sobin LH, Wagner G, Wittekind Ch (eds.). TNM atlas: illustrated guide to the TNM/pTNM classification of malignant tumours, 4th edition. Springer-Verlag: Berlin and Heidelberg, 1997.

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