1. DR:SAMEER A. SOFTA MBBCH, MD, FRCSC ASSISTANT PROFESSOR FACULTY OF MEDICINE UM ALQURA UNIVERSITY MAKKAH

2. GASTRO INTESTINAL MALIGNANCY

3. ESOPHAGEAL CANCER PRESENTATION: DYSPHAGIA 85% REGURGITATION25% WT LOSS 60%HOARSENESS 5% PAIN 25% COUGH 3% PATHOLOGY:SQUAMUS ADENOCARCINOMA PREDISPOSING FACTORS: BARRETTS ESOPHAGUSCAUSTIC INJURY LEUKOPLAKIASCLERODERMA ACHALASIASTRICTURE PLUMMER-VINSON SYNDROME TYLOSIS

4. ESOPHAGEAL CANCER INVESTIGATION:UGIEGDLARYNGOSCOPY CT SCAN EUS STAGING: STAGE I STAGE II STAGE III STAGE IV 1-2 YEARS SURVIVAL 6% & 0.3% RESPECTIVELY TREATMENT: CURATIVE V/S PALLIATIVE CHEMOTHERAPY CHEMOTHERAPYRADITHERAPY

5. GASTRIC CANCER PRESENTATION: PREDISPOSING CONDITIONS: DIET( NITRATE,NITRITE & PICKLED FOODS) ENVIRONMENTAL (SMOKE,DUST,CIGARRETE & ALCOHOL) CHRONIC GASTRITIS (ATROPHIC,G ULCER, ACHLOROHYDRIA, PRENICIOUS ANAEMIA, PRIOR G RESECTION) GENITIC FACTOR BLD GB A INVESTIGATION:EGDUGIEUS CT SCAN

6. GASTRIC CANCER PATHOLOGY:ADENOCARCINOMA SHAPE POLYPOID (SUPERFICIAL) V/S ULCERATING (SCIRRHOUS) TYPE INTESTINAL V/S DIFUSE TYPE SITEDISTAL V/S PROXIMAL LESION size LN INVOLVEMENT TREATMENT: CURE V/S PALLIATION

7. DUEDENAL & SMALL BOWEL CANCER PESENTATION:INVESTIGATION:TREATMENT:

8. PANCREATIC CANCER PRESENTATION:  COURVOISIERS LAW PREDISPOSING CONDITION: CHRONIC PANCREATITIS CIGARRETE SMOKING INVESTIGATION: LFT`S & S AMYLASE US CT SCAN ERCP PERC CT GUIDED BIOPSY !!!!????

9. PANCREATIC CANCER COMPLICATION VIT K DEF (PT ) ASCENDING CHOLANGITIS SEVERE PAIN TREATMENT: CURE:WHIPPLE PROCEDURE PALLIATION: SURGICAL BY-PASS STENT PIC TAIL CATHETER CEALIAC BLOCK CEALIAC BLOCK

10. LIVER CANCER PRESENTATION: PREDISPOSING CONDITION: HEPATITIS B & C ALCOHOLIC L.CIRRHOSIS AFLATOXINSMETABOLICHEMOCHROMATOSISTYROSINEMIAPATHOLOGY: HCCFIBROLAMILARY TYPE ADENOMATOUS HYPERPLASIA METS: LOCALLY: LN, DIAPHRAM DISTANT: LUNG, BONE, ADRENAL, & BRAIN

11. LIVER CANCER INVESTIGATION: BLOOD TEST LFT`S AFP RADIOLOGYUS CT SCAN CT PORTOGRAPHY LIPOIDAL CT SCAN CT/US GUIDED BX TREATMENT: CURATIVE:MULTIMODAL PALLIATIVE:??

12. GALL BLABDDDER & CBD CANCER PRESENTATION: PREDISPOSING CONDITION: GB PORCELAIN GB GALL STONE CBDUC. SCLEROSING CHOLANGITIS PARASITIC INFESTATION CHOLYDOCHAL CYST

13. GALL BLABDDDER & CBD CANCER INVESTIGATION: BLOOD TESTLFT`S S, CEA ASCITIC FLUID TAB RADIOLOGYUS CT SCAN ERCPTREATMENT:CURE:PALLIATION:

14. COLO-RECTAL CANCER PRESENTATION: PREDISPOSING CONDITION: ADENOMATOUS POLYP F/H CA COLON AGE UC CHRON`S COLITIS PREVIOS COLON CAIRRADIATION FAMILIAL POLYPOSISHAMARTOMATOUS POLYP!!!!?

15. COLO-RECTAL CANCER INVESTIGATION: GUAIAC TESTCBC LYTESC. SCOPE BE.CT SCAN US !?S. CEA LEVEL !? TREATMENT:

16. ANAL CANCER PRESENTATION: PREDISPOSING CONDITION: CONDYLOMA CHRONIC ANAL FISSURE CHRONIC ANAL FISTULA INVESTIGATION:US CT SCAN (PELVIS) TREATMENT: SURGERY V/S MEDICAL (RADIATION 5000 cGY & CHEMOTHERAPY,5FU & MITOMICIN-C)

17. ?

18. THANK YOU.