Download PDF
AJP Rep 2011; 01(02): 069-072
DOI: 10.1055/s-0031-1280573
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A Case of Hyperemesis Gravidarum due to Gastric Cancer Masquerading as Preeclampsia

Daniel R. Hersh
1   Queen of the Valley Medical Associates, Napa, California
,
Michael A. Belfort
2   Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas
,
G. Lance White
2   Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas
› Author Affiliations
Further Information

Publication History

Publication Date:
09 June 2011 (online)

   Permissions and Reprints

Abstract

Nausea and vomiting are symptoms frequently seen in normal pregnancy. We report a patient with gastric carcinoma who presented with severe hyperemesis gravidarum that led to extreme volume depletion, hypertension, proteinuria, and acute renal failure. A 35-year-old woman (para 2-1-0-1) with a prenatal course significant for persistent nausea, vomiting, and poor weight gain presented at 36 weeks' gestation with elevated blood pressure (157/114 mm Hg), proteinuria (4+), hypochloremic metabolic alkalosis, and severe intravascular volume contraction. A presumptive diagnosis of severe preeclampsia was made, the patient was given intravenous MgSO4, and cesarean delivery was accomplished uneventfully. When significant emesis persisted in the postoperative period, esophagogastroduodenoscopy revealed an antral/prepyloric mass with a biopsy-proven poorly differentiated adenocarcinoma. To our knowledge, this is the first report of a case of hyperemesis gravidarum with gastric cancer masquerading as preeclampsia.

Keywords

Gastric cancer - hyperemesis gravidarum - preeclampsia - acute renal failure
 

  • References

  • 1 Cunningham FG, MacDonald PC, Gant NF, Leveno KJ, Gilstrap LC , eds. Williams Obstetrics. 19th ed. Norwalk, CT: Appleton & Lang; 1991: 22-
    Google Scholar
  • 2 Pertuiset N, Grünfeld JP. Acute renal failure in pregnancy. Baillieres Clin Obstet Gynaecol 1994; 8: 333-351
    CrossrefPubMedGoogle Scholar
  • 3 Woolf RB. Gastrointestinal complications of pregnancy. In: Gynecology Obstetrics Guide. Vol. 1. Chicago: Commerce Clearing House, Inc.; 1965
    Google Scholar
  • 4 Nesbitt JC, Moise KJ, Sawyers JL. Colorectal carcinoma in pregnancy. Arch Surg 1985; 120: 636-640
    CrossrefPubMedGoogle Scholar
  • 5 Goodlin RC. Preeclampsia as the great imposter. Am J Obstet Gynecol 1994; 164: 1577-1581
    PubMedGoogle Scholar
  • 6 Schwartz SL, Lillehci RC, Shires GT , et al. Principles of Surgery. New York: McGraw Hill Book Co.; 1974: 1082-1083
    Google Scholar
  • 7 Haas JF. Pregnancy in association with a newly diagnosed cancer: a population-based epidemiologic assessment. Int J Cancer 1984; 34: 229-235
    CrossrefPubMedGoogle Scholar
  • 8 Hirabayashi M, Ueo H, Okudaira Y, Matsumata T, Hanawa S, Sugimachi K. Early gastric cancer and a concomitant pregnancy. Am Surg 1987; 53: 730-732
    PubMedGoogle Scholar