Zeitschrift für Gastroenterologie
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The diagnosis of diffuse type gastric carcinoma is very difficult. The delay of diagnosis is often due to false-negative endoscopic and histologic evaluation. The architecture of the stomach can be clearly visualized by endosonography. ⋯ Therefore, the positive predictive value of endosonography in detection of infiltrating malignant tumors was 96.8% in our group. In contrast the accuracy of preoperative histologic diagnosis by biopsies was only 58%. Suspicious results of gastroscopy, especially in combination with a negative biopsy, should lead to further evaluation by endosonography to detect diffuse type gastric cancer earlier.
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We report on a 2.5-year-old boy, who presented with vomiting since one week and periorbital and pitting edema. Laboratory studies revealed hypoproteinemia and hypoalbuminemia without signs of renal or liver disease. The cause of protein loss was giant fold gastritis disclosed by upper endoscopy. ⋯ While the etiology of Ménétrier's disease is still unknown, the benign pediatric hypertrophic gastropathies have been associated with infections, primarily CMV and occasionally helicobacter pylori, herpes simplex and mycoplasma. Supportive treatment with a high-protein-diet and intravenous albumin transfusions is recommended. H2-receptor antagonists might improve symptoms.