Clinical Question-4

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

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Clinical History

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

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Examination

Pallor present

Blood parameters

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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

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Ultrasonogram abdomen

 Minimal -ascites, pleural effusion

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

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Endoscopy

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Hypertrophic gastric folds resembling cerebral convolutions

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Endoscopy revealed

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

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Hypertrophic gastric folds resembling cerebral convolutions

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

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A. Zollinger-Ellison syndrome

B. Menetrier disease

C. Portal hypertensive gastropathy

D. Achlorhydria

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ALL are TRUE for Histopathological examination of Menetrier disease EXCEPT

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A. Foveolar hyperplasia

B. Oxyntic glands hypertrophy

C. Reduction in parietal cells

D. Chief cells

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

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A. Sleeve gastrectomy

B. Partial gastrectomy

C. Gastric ablation

D. Total gastrectomy

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In shorts

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Menetrier disease is excessive mucosal hypertrophy associated with protein loss.

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Other names for Menetrier disease

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1. Hypoproteinemic hypertrophic gastropathy
2. Giant hypertrophic gastritis

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Most commonly involved parts in Menetrier disease

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

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