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• Background: Nausea and vomiting is a common entity of pregnancy. 7 out of 10 women experience some level of NVP. Gastric cancer with pregnancy in one of a rarest cause of NVP complicating 0.026-0.1% of all pregnancy worldwide.
• Case: A 25 years primigravida presented to Dr.BRAM hospital with severe IUGR and severe vomiting, tolerating liquid diet only. She was thin built, brittle discolored rough hairs with cracked lips and angular cheilosis. She had tachycardia but BP was normal. All her routine investigations were within normal range except mildly elevated liver enzymes. She was investigated for her persistent vomiting with consultation from physician and surgeon. USG whole abdomen to rule out other causes of vomiting showed thickening of stomach wall. MRI – asymmetrical circumferential thickening of antropyloric region of stomach. Endoscopic biopsy-showed diffuse infiltrative adenocarcinoma (signet ring cell). Her nutritional deficiency was managed. She had preterm vaginal delivery; baby was handed over after 35days of birth. She received neoadjuvant chemotherapy followed by surgery and radiotherapy tolerating semisolid food well.
• Conclusion: Severe, persistent and nonresponsive NVP associated with weight loss should be investigated vigilantly and thoroughly. Apart from other causes one of rarest cause i.e., gastric carcinoma should not be missed. Diagnosis in early stage and management can have better prognosis and prolong the life expectancy.
• Keynotes: NVP, gastric carcinoma in pregnancy, Severe IUGR….
