Anterior abdominal wall abscess: A rare presentation of advanced carcinoma of the stomach

Abstract

Surgeons often encounter patients with advanced carcinoma of the stomach that necessitate urgent operative interventions. The presentations include perforation-peritonitis, bleeding, and gastric outlet obstruction. Carcinoma of the stomach is known to invade surrounding organs such as the transverse colon, pancreas, spleen, liver, and rarely, the anterior abdominal wall. In this case report, we describe an elderly diabetic male patient who presented with a large anterior abdominal wall abscess. The contrast-enhanced computed tomography scan of the abdomen showed a communication from the pylorus of the stomach to the abscess cavity. He underwent drainage of the abscess, and the wound was transiently managed with a vacuum-assisted closure. On gastroscopy, a fistulous opening was noted in the pylorus with surrounding erythema. The biopsy from the lesion was reported as a poorly differentiated adenocarcinoma with signet-ring cells. Anterior abdominal wall abscess is a rare presentation of carcinoma stomach and when identified, the primary aim of the treatment should be the sepsis control and wound healing followed by definitive management.