In this condition, despite the growing feeling of hunger, patients try to eat as little as possible because of the fear of the occurrence of food-related pain, and sometimes because of aversion to food. Such patients often begin to wash the stomach daily, after which they feel great relief. However, the amount of water and nutrients entering the body does not increase, and patients are steadily beginning to deplete and dehydrate.
In some patients, with the defeat of the exit section, the obstruction not only does not develop, but on the contrary, the gatekeeper infiltrated with cancer, having lost the ability to contract, is a hard, gaping tube through which all food that has entered the stomach freely falls. A similar phenomenon can be observed even when part of the pyloric wall remains free from the tumor, however, the pylorus does not contract and does not close the exit from the stomach due to
defeat of the corresponding nerve devices or due to the loss of the reflex in the absence of normal secretion of gastric juice and, in particular, the absence of hydrochloric acid in it. The rapid transition of undigested food into the intestine leads to a constant feeling of hunger, in connection with which patients begin to eat a lot, but despite this, they are quickly depleted, because the accepted food in the intestine is poorly absorbed. The stool in such patients is frequent, fluid, with a large number of undigested food particles. It is necessary to think that the involvement of the pancreas in the process plays a big role in this connection, and therefore not only the gastric and pancreatic digestion is turned off.
Many patients come to the surgeon only when they have already managed to probe the cancer through the abdominal wall. This mainly refers to tumors of the lower third of the stomach. A tumor located at the entrance to the stomach or at the bottom of it, it is possible to palpate only in exceptional cases - with very large sizes in thin patients with flabby abdominal wall of patients; during deep breathing of the patient, when due to the displacement of the stomach together with the tumor down it comes out from under the left costal arch. In this case, palpation is only the lowest part. Note that when cancer is located in the upper third of the stomach, tumorous formations that are palpated in the left hypochondrium are most often not the main tumor, but metastatic nodes in the area of the greater curvature of the stomach, in the gastrocolic ligament, in the omentum or in other adjacent formations.
Most often it is possible to probe the tumor of the output section - the pylorus and the antral part. These are solid, lumpy, to some extent painful formations, easily mobile until they grow into adjacent organs that have low mobility. Such a tumor is mobile not only when breathing, moving down during inhalation, but upward during expiration, but it can easily be displaced by the examining hand, sometimes by a considerable distance. Often, such tumors do not lose this ability even when they germinate in the transverse colon and even in the pancreas, which in some people, especially the exhausted, many giving birth to women with a flabby stomach, can be very mobile. It is possible to hold the tumor with the hand and even with deep breathing to hold it in place, if it is not connected with the liver, if it is somehow connected with the liver, then it is not possible to hold it with the hand during breathing. When you exhale, she will definitely leave from under the arm following the upward moving liver.
It should be borne in mind that the stomach can be covered by the left liver lobe, which is affected by cancer, which, increasing down and to the left, is located between the abdominal wall and the stomach, sometimes closing the transverse colon. This is usually the case with metastatic lesions. Then a dense and knobby tumor, felt in the epigastrium, can be mistaken for a tumor of the stomach. However, it is not possible to capture it with the hand and hold it during breathing, just like those stomach tumors that are firmly adhered to the liver.