AP image from an upper GI shows an abnormal appearance of th | Figure 1

CincyKidsRad

Cincinnati Children's Radiology

AP image from an upper GI shows an abnormal appearance of the stomach. There is a gastric ulcer with a focal outpouching of the gastric body (arrow) and heaped up walls. A second ulcer is present more superiorly (arrowhead). This ulcer lead to perforation and free leakage of contrast was seen on upper GI. Our understanding of H. Pylori and its causative relationship with gastric ulcers has led to a shift in how patients with ulcer are diagnosed. It is now rare to make these findings on upper GI. #TummyTuesday

More about this case

ResolvedRare

Why you should join Figure 1

• Share your knowledge with our global community of healthcare professionals
• Get help from experts in your field
• Learn from our library of real-world cases and quizzes

Similar cases

Gastric ulcer perforation](https://app.figure1.com/case-detail/3a327bd5-2657-4642-8b67-a2d7e37af40c)

Axial (image 1) and coronal (image 2) contrast-enhanced CT shows asymmetric wall thickening (arrow) of the stomach. This was later confirmed to represent a glomus tumor. The differential diagnosis for a gastric mass includes a GI stromal tumor, lymphoma, gastric ulcer disease, and a glomus tumor. Glomus tumors are rare tumors of the stomach and are almost always benign. Typically, glomus tumors occur in the subungual region of fingers. However, they can occur anywhere in the body. In the stomach, they appear as a submucosal nodule at the gastric antrum.

Axial CT images of the abdomen shows a gastric ulcer (arrow) near the pylorus. The duodenal bulb (arrow) is normal. The gastric antrum wall (arrowhead) is thickened. Gastric ulcers are typically caused by H. pylori infection or medication use. Patients may present with pain, upper GI bleeding, and acute pain related to perforation.

Upper GI examination in a child status post gastric banding shows two ulcers (arrow and dashed arrow). The larger ulcer (arrow) has heaped up edges and an “out-pouching” of contrast. The outpouching represents the ulcer crate. Today, gastric ulcers are rarely diagnosed on upper GI. Instead, most are diagnosed with endoscopy or treated empirically. #TummyTuesday