|
KMID : 0856920060090010035
|
|
Journal of Hospice and Palliative Care
2006 Volume.9 No. 1 p.35 ~ p.39
|
|
|
Panperitonitis with Advanced Gastric Cancer -Based on Seminar of Korean Family Medicine Palliative Medicine Research Group-
|
|
Jung Yun-Joo
Shim Jae-Yong
Kim Dae-Kyun
Choi Youn-Seon
|
|
|
Abstract
|
|
|
|
A 77-year-old female presented panperitonitis due to advanced gastric cancer during palliative care. In the case of panperitonitis following obstruction or perforation, surgical treatment is vital to avoid fatal sepsis and dehydration. However, the risk of surgery and the residual life of a patient must be carefully considered because of high mortality and complication rate in those patients with advanced disease due to the poor condition. The therapeutic value of aggressive hydration, nasogastric tube insertion, and the use of antibiotics is also questionable. Palliative surgery was not performed on this case, and she passed away peacefully in the presence of family after 4 days of palliative medical care. Here is the appropriate management for this kind of patients we would like to recommend through review of relevant references and long discussions. Firstly, we need to predict survival time using clinical variables. Secondly, considering patient status and risk of surgery, non surgical palliative care such as pain control, transient nasogastric tube insertion, and parenteral hydration is recommended. Minimal use of fluid is desirable to minimize complications such as edema and dyspnea if massive hydration in the beginning of treatment is not proved to be effective. Even though started earlier in the course of disease, discontinuation of antibiotics could be discussed with patients and their caregiver if patient status is not improved. (Korean J Hosp Palliat Care 2006;9:35-39)
|
|
|
KEYWORD
|
|
|
Advanced gastric cancer, Panperitonitis, Parenteral hydration nasogastric tube, Palliative medicine
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
  
|
|