2023 Volume 43 Issue 7 Pages 1101-1104
The patient was a 50-year-old man who presented with orbital pain. Contrast-enhanced CT showed a 4-cm mass in the anterior gastric wall. Abdominal endoscopic ultrasound showed a mass lesion within the anterior gastric wall that was uniformly hypo-echoic, with purulent discharge inside; based on the finding, we made a diagnosis of idiopathic gastric wall abscess. The patient improved with intravenous cefmetazole. On day 9, a blood test showed a decrease in the levels of inflammatory response markers, but CT showed a residual gastric wall abscess, and levofloxacin was added to the treatment. A repeat CT on day 40 showed a reduction in the abscess size. Gastric wall abscess is a rare condition that is important to keep in mind when considering the differential diagnosis of gastric submucosal masses, as it may be difficult to distinguish from a gastric submucosal tumor by CT. Endoscopic ultrasound may be useful for its diagnosis. If diagnosed early and correctly, gastric wall abscesses could be successfully treated by drainage and antibiotics.
