CT of Acute Abdomen

Epigastric Pain series 1 RESIDENT COURSE Answer [ER Case 3]

AGML (acute gastric mucosal lesion).



The body of stomach (Fig.1-Fig.3) shows no thickening of wall. Black arrowheads of Fig.4-Fig,7 demonstrate circumferential edematous wall thickening limited to gastric antrum. Because no distinct defect of wall suggestive of ulcerative lesion is identified, most likely diagnosis is AGML( acute gastric mucosal lesion). Black arrow of Fig.1 is not an acute ulcer but a gastric fold because of no surrounding edematous wall thickening. Fig.A is the endoscopic finding which reveals edematous wall thickening of entire gastric antrum, erosions and clots which are characteristic of AGML.






Reference case (AGML): A 52-year-old male with epigastric pain of 24 hours duration.
Black arrowheads of Fig.4–Fig.9 depict circumferential wall thickening of antrum due to submucosal edema indicating AGML. Endoscopy revealed AGML with shallow ulcers (Fig.A: black arrows) and mildly edematous mucosa.











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