Clinical Question-4


What is the most probable diagnosis of the following Clinical case?


Clinical History


61 year male came to medicine department with history of Symptoms: upper abdominal discomfort, loss of appetite, weight loss for 4 months


Examination

Pallor present

Blood parameters


  1. Liver function tests – normal
  2. Renal parameters – normal
  3. Serum albumin – 2.1.0 mg/dl.
  4. Hemoglobin -8.1 g%

Found to have – anemia and hypoproteinemia


Ultrasonogram abdomen

 Minimal -ascites, pleural effusion

Ultrasonogram abdomen – showed diffuse wall thickening involving the fundus of the stomach


Endoscopy


Hypertrophic gastric folds resembling cerebral convolutions


Endoscopy revealed

  1. Hypertrophic gastric folds resembling cerebral convolutions
  2. Folds involving fundus and body of stomach and antrum was spared



Hypertrophic gastric folds resembling cerebral convolutions


What is the most probable diagnosis of the following Clinical case?


A. Zollinger-Ellison syndrome

B. Menetrier disease

C. Portal hypertensive gastropathy

D. Achlorhydria



ALL are TRUE for Histopathological examination of Menetrier disease EXCEPT


A. Foveolar hyperplasia

B. Oxyntic glands hypertrophy

C. Reduction in parietal cells

D. Chief cells



Which is preferred in severe cases with intractable abdominal pain and severe pyloric obstruction?


A. Sleeve gastrectomy

B. Partial gastrectomy

C. Gastric ablation

D. Total gastrectomy



In shorts


Menetrier disease is excessive mucosal hypertrophy associated with protein loss.


Other names for Menetrier disease


  1. Hypoproteinemic hypertrophic gastropathy
  2. Giant hypertrophic gastritis

Most commonly involved parts in Menetrier disease


Mainly the proximal part of the stomach (body and fundus) and spares the distal portion (antrum)


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