Gastric Ulcer Perforation with Subsequent Gastric Wall Abscess Mimicking Submucosal Tumor Detected by Endoscopic Ultrasound

Abstract

Sealed-off perforated gastric ulcer at the posterior wall is very difficult to detect because of the vague symptoms and nonspecific radiologic signs. Gastric wall abscess is a rare complication of peptic ulcer disease and is associated with a high mortality rate. We report a 66-year-old woman with a sealed-off perforated gastric ulcer, with subsequent abscess formation in the gastric wall mimicking a gastric submucosal tumor that was detected by endoscopic ultrasonography. Endoscopic ultrasonography revealed two fusiform hypoechoic masses originating from the muscularis propria of the posterior wall of the gastric body. Klebsiella pneumoniae was cultured from the gastric abscess, and the patient was successfully treated with subtotal gastrectomy.