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Case Reports
. 2023 Sep 18;16(9):e256724.
doi: 10.1136/bcr-2023-256724.

Large gastric ulcer presenting as gastric pneumatosis

Michael Ladna  1 , John George  2 , Christopher Forsmark  2
Affiliations
Case Reports

Large gastric ulcer presenting as gastric pneumatosis

Michael Ladna et al. BMJ Case Rep. .

Abstract

A man presented with nausea, vomiting, abdominal pain and diarrhoea. Cross-sectional imaging of the abdomen and pelvis showed gastric pneumatosis. He was treated conservatively with broad-spectrum antibiotics, bowel rest, nasogastric tube placement for gastric decompression and intravenous proton pump inhibitor therapy. He developed an upper gastrointestinal bleed during hospitalisation and underwent an esophagogastroduodenoscopy (EGD) which revealed a large >50 mm cratered gastric ulcer. Initial biopsy was inconclusive for malignancy thus a repeat EGD was scheduled however prior to that procedure he returned to the emergency department with severe abdominal pain. CT of the abdomen and pelvis showed recurrence of gastric pneumatosis. Repeat EGD showed a 4 mm linear gastric ulcer and repeat biopsies showed gastric mucosa with moderate chronic inactive gastritis without any metaplasia, dysplasia, carcinoma or amyloid. He was once again treated successfully with conservative measures and discharged after short hospitalisation.

Keywords: Endoscopy; GI bleeding; Stomach and duodenum; Ulcer.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
CT abdomen and pelvis images of gastric pneumatosis axial plane and coronal plan on day of first admission.
Figure 2
Figure 2
Esophagogastroduodenoscopy images showing the large >50 mm gastric ulcer.
See this image and copyright information in PMC

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