GASTRIC WALL ABSCESS, A RARE ENDOSONOGRAPHIC DIFFERENTIAL-DIAGNOSIS OF INTRAMURAL TUMORS - SUCCESSFUL ENDOSCOPIC TREATMENT

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.