Chronic gastro-abdominal wall fistula with secondary massive thoracoabdominal wall abscess and costal destruction after laparoscopic gastricolithotomy: A case report

Figure 1 Chest and abdominal wall abscess shown on computed tomography. A: Abscess on chest wall (arrow: Abscess on chest wall); B-D: Abscess all over abdominal wall (arrow: Abscess all over abdominal wall).

Figure 2 Upper gastrointestinal radiography showed that the gastric wall was irregular and tentacle-like. A and B: View from front; C: View from behind. Arrow: The gastric wall was irregular and tentacle-like.

Figure 3 Abdominal enhanced computed tomography scan findings. A: A thick gastric wall, and local discontinuity of the gastric wall in the greater curvature of the anterior gastric wall (arrow); B: A gas shadow in the gastric cavity also formed an outer bulge (arrow); C: Soft tissue swelling of thoracoabdominal wall (arrow); D: Rib destruction (arrow).

Figure 4 Gastric endoscopy showed a gastric ulcer. A: A 1.8 cm × 1.2 cm deep ulcer on the anterior wall of the gastric body, with thick yellow material and hyperplastic tissue at the edge (arrow); B: The original surgical suture line was visible (arrow).

Figure 5 Abdominal computed tomography scan showed improvement in thoracoabdominal wall swelling. Abdominal computed tomography scan showed (white arrow) improvement in thoracoabdominal wall swelling.

Figure 6 Gastric ulcer, stage A2. A and B: Gastric body: Mucosal blotchy congestion and erosion, a 1.5 cm × 0.8 cm ulcer with white material and a clear mucus pool on the anterior wall of the greater curvature. Arrow: Ulcer.

Figure 7 Repeated abdominal computed tomography on January 7, 2021 showed complete recovery. A: Healed chest wall (arrow); B: Healed stomach wall (axial plane) (arrow); C: Healed stomach wall (coronal plane) (arrow).

Figure 8  Timeline about diagnosis and treatment of the patient.