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.
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机译：恶心和呕吐是正常妊娠中常见的症状。我们报告了一名患有严重妊娠呕吐的胃癌患者，该妊娠呕吐导致极度体力消耗，高血压，蛋白尿和急性肾衰竭。一名35岁妇女（第2-1-0-1段）的产前病程，在妊娠36周并伴有血压升高（157/114 mm Hg）时，表现出持续的恶心，呕吐和体重增加不良，蛋白尿（4+），低氯性代谢性碱中毒和严重的血管内容积收缩。对严重先兆子痫作出了推定性诊断，对该患者进行了静脉内的MgSO 4 给药，剖宫产顺利完成。当术后出现严重的呕吐时，食管胃十二指肠镜检查显示肛门/前幽门肿块，并经活检证实为低分化腺癌。据我们所知，这是第一例妊娠呕吐伴胃癌伪装为先兆子痫的病例。
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