2022 Volume 64 Issue 11 Pages 2378-2384
A 26-year-old woman presented to a local clinic for abdominal pain and fever. She was referred to our hospital for treatment of a gastric submucosal tumor-like lesion, which was detected at the local clinic. Endoscopy revealed a submucosal tumor-like lesion with a depression at the apex in the gastric antrum. Contrast-enhanced CT revealed a cystic lesion (approximately 40mm) with increased density of surrounding fatty tissue, which was diagnosed as a gastric wall abscess. Abdominal pain and fever persisted despite conservative management using antibiotic therapy, and we performed endoscopic ultrasound-guided drainage. The aspirated fluid was purulent with abnormally high levels of pancreatic enzymes. These findings indicated a rare case of gastric wall abscess that originated from gastric ectopic pancreas. Symptoms improved with the treatment, and post-discharge contrast-enhanced CT revealed disappearance of the cystic lesion and partial reduction of the submucosal tumor-like lesion. This clinical course suggests that endoscopic ultrasound-guided drainage may be a safe and effective treatment for a gastric wall abscess that originated from the gastric ectopic pancreas.
