EC Clinical and Medical Case Reports

Gastric malignancy perforation is rare and may present with nonspecific or extra-abdominal symptoms, delaying diagnosis. We present the case of a 64-year-old man who presented with dyspnea and undifferentiated shock with minimal abdominal signs but massive free abdominal fluid and air. Emergency laparotomy revealed diffuse purulent peritonitis and a 5 cm antral perforation due to a perforated gastric adenocarcinoma. In conclusion, perforated gastric cancer can present primarily with shock and few abdominal signs. Rapid ultrasound/CT diagnosis and a staged damage-control surgical strategy with secondary definitive resection improve chances of survival.

Keywords: Gastric Malignancy Perforation; Gastric Cancer; CT Diagnosis

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