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Gastric ulcers

Case contributed by Michael P Hartung
Diagnosis certain

Presentation

Epigastric pain.

Patient Data

Age: 35 years
Gender: Male
ct

Circumferential, low-attenuation thickening of the distal gastric body and antrum. An area of ulceration can be appreciated along the greater curve of the antrum on the coronal image. No adenopathy. No free fluid or air. 

Endoscopy

Upper Endoscopy report:

The examined esophagus was normal. Three non-bleeding superficial gastric ulcers with no stigmata of bleeding were found in the gastric antrum. The largest lesion was 6 mm in largest dimension. Biopsies were taken with a cold forceps for histology. Diffuse moderate inflammation characterized by congestion (edema) and erythema was found in the gastric antrum. Biopsies were taken with a cold forceps for histology.

Case Discussion

Three gastric ulcers were responsible for the circumferential, low-attenuation thickening of the distal gastric body and antrum. The major differential in this case would be lymphoma. However, lymphoma would have soft-tissue attenuation, not the low-attenuation thickening in this case which indicated edema. 

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