CT of Acute Abdomen

Epigastric Pain series 1 RESIDENT COURSE Answer [ER Case 2]

Gastric ulcer.



White arrows of Fig.2-Fig.4 represent fatty tissue. No free air or ascites is identified. Beginning with Fig.3, the wall of lesser curvature of stomach is edematous and thickened (black arrowheads), extending to posterior wall of antrum. Black arrows of Fig.6 and Fig.7 show a defect in edematous wall (black arrowhead), which is highly suggestive of an acute ulcerative lesion. Endoscopy showed an active ulcer at posterior wall of gastric angle (Fig.A: white arrowheads).







Reference case (gastric ulcer): An 83-year-old male had been suffering from increasing epigastric pain for three days.
The wall thickening of lesser curvature of stomach begins with Fig.1 (black arrowhead) and extends to posterior wall of antrum of Fig.9. Black arrows of Fig.4-Fig.7 indicate an ulcerative lesion that extends from lesser curvature of gastric angle to posterior wall of stomach. The findings were confirmed by endoscopy (Fig.A: white arrowheads).











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