Abstract
This paper presents a case of abscess of the gastric wall associated with intraabdominal abscess.
A 73-year-old woman was seen at the hospital because of abdominal pain and general fatigue. Echography visualized a swelling of the gallbladder. The patient was admitted with a diagnosis of acute cholecystitis and conservatively treated. Temporal symptomatic remission was attained but fever and an increase in CRP were noted. Abdominal CT scan revealed the swollen gallbladder and retention of alarge volume of ascites on the dorsum of both left hepatic lobe and spleen and on the posterior wall of the stomach, and so intraabdominal abscess was diagnosed. We performed a PTGBD which identified E. aerogenes and an intraabdominal abscess drainage which identified K. oxytoca and P. aeruginosa. After the drainage, purulent ascites decreased and we were able to initiate surgery. During surgery, an 8×6cm submucosal tumor like lesion was present under mucosa of the posterior wall of lower body of stomach. A distal gastrectomy and a partial resection of the transverse colon were performed. Purulent discharge similar to intraabdominal abscess was collected from the lesion, and its culture yielded K. oxytoca. Histological diagnosis was gastric wall abscess mainly involving SS. Considering the results of cultures with other findings, the intraabdominal abscess in this case might be caused by the gastric wall abscess.
