Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 28, 2015; 21(20): 6398-6403
Published online May 28, 2015. doi: 10.3748/wjg.v21.i20.6398
Gastric subepithelial lesion complicated with abscess: Case report and literature review
Sung Bum Kim, Myung Jin Oh, Si Hyung Lee
Sung Bum Kim, Myung Jin Oh, Si Hyung Lee, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 705-802, South Korea
Author contributions: All authors contributed to designing the report and edit and writing of the manuscript; Lee SH supervised, proof-read and made corrections required.
Ethics approval: The study was reviewed and approved by the institutional review board of Yeungnam University Hospital.
Informed consent: The patient has signed the informed consent.
Conflict-of-interest: No conflict-of-interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Si Hyung Lee, MD, Department of Internal Medicine, Yeungnam University College of Medicine, 170 Hyeonchung-ro, Nam-gu, Daegu 705-802, South Korea. dr9696@nate.com
Telephone: +82-53-6203830 Fax: +82-53-6548386
Received: October 31, 2014
Peer-review started: October 31, 2014
First decision: November 26, 2014
Revised: December 10, 2014
Accepted: January 30, 2015
Article in press: January 30, 2015
Published online: May 28, 2015
Abstract

Gastric abscess is a localized pyogenic inflammation of the gastric wall, which is a rare form of suppurative gastritis. The rarity of gastric abscess may be associated with the difficulty of early diagnosis and high mortality as a result. In general, subepithelial lesions (SELs) of the stomach are incidentally detected during the course of upper endoscopy without specific clinical symptoms and signs. However, some gastric SELs present rarely as a form of hemorrhage, obstruction, perforation, and abscess. Here we report a 45-year-old man with gastric SEL presenting as a gastric abscess, which was diagnosed as an ectopic pancreas of the stomach, along with a review of the literature. Although gastric SEL presenting as an abscess is known as a serious and life-threatening lesion, the patient made a complete recovery through surgical resection as well as medical treatment.

Keywords: Suppurative gastritis, Gastric abscess, Subepithelial lesion, Ectopic pancreas, Endoscopic ultrasound

Core tip: Suppurative gastritis is a rare disorder characterized by a purulent, exudative inflammatory process involving the submucosa that may extend to involve the entire gastric wall and may be divided into two categories: phlegmonous, or diffuse type; and localized, gastric abscess type. Predisposing conditions of phlegmonous gastritis or gastric abscess include alcoholism, diabetes mellitus, decreased gastric acidity, and immunosuppression, such as HIV infection. High mortality rate of suppurative gastritis, between 37% and 84%, has been reported. Medical treatment, such as endoscopic drainage and antibiotics, and surgical resection of the mass should be considered.