Epigastric Pain

The most typical symptom of gastric cancer is disturbed patency of the gastrointestinal canal, which is narrowed by the growing tumor. It is evident that such disorders will be the relatively early and more pronounced signs of tumor in the cardiac and pre-pyloric parts, the pylorus included, because these are the most narrow portions of the stomach cavity. And these symptoms may be absent if the tumor is located in the stomach body or the fundus, especially on the greater curvature or the anterior wall of the stomach.

The feeling of an overfilled epigastrium is believed to be the sign of the initial process of obstruction of the pylorus, the antral, and the prepyloric parts. In other words, this feeling is characteristic of cancer. At the same time, development of the obstructive symptoms in the presence of invasive carcinoma in the pyloric part, which causes its steno-

□ Fig. 22 a.

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