Perforation of Gastric Ulcer into the Giant Cyst of the Liver: Report of a Case

Abstract

We reported an extremely rare case of a gastric ulcer perforating into a cyst. A 78-year-old man seen in December 2005 for severe epigastralgia was found in plain computed tomography (CT) to have a giant liver cyst containing gas. Laparotomy showed the stomach had adhered to the cyst. This and the presence of a gastro-cystic fistula yielded a diagnosis of gastric ulcer perforation into a liver cyst with localized peritonitis. Using a surgical stapler, we transected the cyst wall from the stomach and drained the cyst. Proton pump inhibitor was administered postoperatively for an active ulcer in the lesser curvature of the gastric body. Pathological findings showed no malignancy. The man was discharged following a smooth postoperative course. The definitive diagnosis was gastric ulcer perforating into a liver cyst. The man remains well without liver cyst recurrence in the half year since surgery.