OpenOnco
UA EN
Plan Builder Onco Wiki Tumor Board

Onco Wiki / Red flag

Surgical/endoscopic emergency in gastric/GEJ adenocarcinoma: massive upper-GI bleed requi...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

IDRF-GASTRIC-EMERGENCY-BLEED-OBSTRUCTION
TypeRed flag
Statusreviewed 2026-04-26 | pending_clinical_signoff
DiseasesDIS-GASTRIC
SourcesSRC-ESMO-GASTRIC-2024 SRC-NCCN-GASTRIC-2025

Red Flag Origin

DefinitionSurgical/endoscopic emergency in gastric/GEJ adenocarcinoma: massive upper-GI bleed requiring transfusion, gastric outlet obstruction with intolerance of oral intake, or perforation. Mandates urgent endoscopic / surgical / interventional management BEFORE systemic therapy initiation.
Clinical directionhold
Categoryorgan-dysfunction

Trigger Logic

{
  "any_of": [
    {
      "finding": "massive_upper_gi_bleed",
      "value": true
    },
    {
      "finding": "gastric_outlet_obstruction_npo",
      "value": true
    },
    {
      "finding": "gastric_perforation",
      "value": true
    }
  ],
  "type": "composite_score"
}

Notes

~30% of gastric cancer presents with obstruction or bleeding. Endoscopic stenting OR palliative/diversion surgery + nutritional support BEFORE chemo. Bevacizumab/ramucirumab additionally contraindicated for ≥28 days post-surgery.

Used By

Algorithms

Indications