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Abdomen » Gastrointestinal
Gastric wall abscess
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Author(s) :
Deepak Chawla, MD
 
Presentation A 24 years old staff nurse presented with burning in the epigastrium. She had no other complaints and an abdominal ultrasound was performed.
 
 
 
Caption: Midline transverse view of the abdomen
Description: The anterior wall of the stomach appears thickened and shows a very subtle focal bulge protruding into the gastric lumen, as marked by the arrow. The visualized pancreas appears normal.
 
 
 
Caption: Transverse image of the abdomen
Description: The visualized pancreas and the pyloric region appear normal. No abnormality is seen in this image.
 
 
 
Caption: Endoscopic view of the stomach at pylorus
Description: A focal bulge is seen in the anterior wall of the stomach. The overlying mucosa is erythematous but shows no ulcerations or irregularity.
 
 
 
Caption: Magnified endoscopic view of the area of interest
Description: A submucosal mass is identified in this image with the overlying mucosa appearing inflamed.
 
 
 
Caption: Endoscopic ultrasound image
Description: A well-defined hypoechoic mass is identified mainly in the submucosal region. No irregularity of its margins or surrounding layers is noted.
 
Differential Diagnosis The  differential diagnosis would be a benign submucosal tumor such as polyp, lipoma, leiomyoma and abscess.
 
Final Diagnosis Gastric wall abscess. When the mass was seen on endoscopy and endosonography, a tumor was suspected and biopsy was attempted. Frank pus was aspirated and culture yielded pneumococcus. The source of this infection could not be traced.
 
Follow Up The patient underwent treatment and follow up endoscopy and imaging revealed complete resolution of the disease.
 
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