U. Will et al., GASTRIC WALL ABSCESS, A RARE ENDOSONOGRAPHIC DIFFERENTIAL-DIAGNOSIS OF INTRAMURAL TUMORS - SUCCESSFUL ENDOSCOPIC TREATMENT, Endoscopy (Stuttgart), 30(4), 1998, pp. 432-435
Abscesses in the gastric wall are extremely rare. As the mucosa remain
s intact in most cases, clear differential diagnosis is required in or
der to distinguish the condition from the more frequent intramural mes
enchymal tumors. Endoscopic ultrasonography provides a valuable tool f
or imaging intramural tumors, but this approach does not allow a defin
itive assessment of malignancy. We report about two patients with intr
amural abscesses in the gastric wall. Endosonography showing eccentric
tumors from the gastric wall in the two patients. The endosonographic
image was inhomogenous, the wall layer structure of the gastric wall
was not preserved. A laparotomy was carried out on the first patient.
In the second case, the diagnosis was easy, as pus was emptying from a
small opening in the mucosa, which had already been detected at gastr
oscopy, Endoscopic intervention was carried out based on the endosonog
raphic findings. In one patient, mucosa and submucosa were opened by a
needle knife, These cases show that gastric wall abscesses do not hav
e a typical endoscopic ultrasound appearance. However, endosonography
is an essential method prior to endoscopic interventional therapy.