Diagnostic challenges in differentiating intramural gastric abscess from gastric cancer

Chen, You‐Wei; Han, Yong; Du, Jing

doi:10.1097/md.0000000000012756

Cited by 9 publications

(13 citation statements)

References 11 publications

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“…GC is a common malignant tumor, especially in middleaged and elderly populations (10,11). GC progresses rapidly, and thus accurate assessment of its preoperative stage, lymph node metastasis, and EMVI is particularly important for surgical planning and prognostic prediction (12,13).…”

Section: Discussionmentioning

confidence: 99%

Value of multiphase contrast-enhanced CT with three-dimensional reconstruction in detecting depth of infiltration, lymph node metastasis, and extramural vascular invasion of gastric cancer

Wang¹,

Zhong²,

Zhou³

et al. 2021

J Gastrointest Oncol

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Background: Multiphase contrast-enhanced computed tomography (CECT) can reveal the location, morphology, size, and enhancement pattern of gastric cancer (GC), whereas the three-dimensional reconstruction (3DR) technique can better display the relationships of the lesions with surrounding structures, the feeding vessels, and lymph node metastasis. Here, we investigated the value of multi-phase CECT with 3DR in detecting depth of infiltration, lymph node metastasis, and extramural vascular invasion (EMVI) of GC. Methods: The clinical and imaging data of 132 GC patients admitted to the Chongqing Hospital of Traditional Chinese Medicine and the Third Affiliated Hospital of Chongqing Medical University during the period from January 2012 to October 2019 were collected. All patients received plain and multiphase contrast-enhanced CT scans. The agreement between the results of preoperative CT evaluation and the surgical/pathological findings was compared.Results: (I) CT findings of GC of 3 differentiation levels: on the multiphase CECT, the peak enhancement percentage was highest in the portal venous phase. the CT values significantly differed among the arterial, portal venous, and equilibrium phases (P<0.05); the differences in the arterial, portal venous, and equilibrium phases were statistically significant among the well-, moderately, and poorly differentiated groups (all P<0.05); finally, the difference in the equilibrium phase was statistically significant between the well-and moderately differentiated groups (P<0.05). (II) Preoperative CT and postoperative pathology had good consistency in T staging (Kappa =0.667). (III) The Kappa values between the preoperative CT-diagnosed lymph node metastasis and postoperative pathologically showing an increasing consistency with the increase of CT enhancement differences. (IV) Preoperative CT and postoperative pathology had good consistency in N staging (Kappa =0.779). (V) Preoperative CT in displaying arterial supply to the stomach. The rate of positive EMVI was 32.6% (43/132) on preoperative CT. The positive EMVI diagnosed by preoperative CT was correlated with tumor size, growth pattern, tissue differentiation degree, T stage, and N stage (all P<0.05).Conclusions: Multiphase CECT combined with 3DR has high diagnostic performance in detecting the depth of infiltration, lymph node metastasis, and EMVI of GC.

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Section: Discussionmentioning

confidence: 99%

Value of multiphase contrast-enhanced CT with three-dimensional reconstruction in detecting depth of infiltration, lymph node metastasis, and extramural vascular invasion of gastric cancer

Wang¹,

Zhong²,

Zhou³

et al. 2021

J Gastrointest Oncol

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“…Gastric wall abscess was first described by Cruveilhier in 1862 [ 4 ], it is a rare pathology of stomach's wall. This may be attributed to the fact that the stomach is an unfavorable place for bacterial growth due to its acid secretions and rich blood supply to the gastric wall, However, it could be underdiagnosed because of the lack of specific clinical symptoms and it's easily confused with gastric cancer [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Gastric wall abscess: A case report and literature review

Qafisheh

Dukmak

AbuRumella

et al. 2022

Annals of Medicine &Amp; Surgery

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“…They can be easily misdiagnosed as leiomyoma, leiomyosarcoma, neuroendocrine tumors, inflammatory polyps and many other benign or malign lesions [16]. They can also be confused with abscesses as other studies have shown [17].…”

Section: Discussionmentioning

confidence: 99%

A Rare Form of Presentation of a Small Intestine Gist in the Emergency Department

Păduraru

Ion

Bolocan

et al. 2021

RoJES

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Gastro-intestinal stromal tumors are a form of mesenchymal tumors most commonly located in the gastro-intestinal tract, as the name suggests. The symptoms that might occur can be abdominal pain or discomfort, early satiety, bloating, jaundice, fatigue, hematemesis or melena. Most of GISTs (>95%) are positive for the KIT protein. Surgery remains the only curative treatment for GIST amenable for resection. High risk tumors can receive adjuvant or neoadjuvant treatment with Imatinib Mesylate, a tyrosin-kinase inhibitor. We present the case of a 59-years old patient that presented with rectal bleeding and abdominal diffuse pain. Blood tests shows leukocytosis and moderate anemia. CT scan describes an expansive, polycyclic process projected at the limit between the mesogastric region and the left flank, in close contact with the small intestine without any clear demarcation line between them and at the superior pole of the tumor, located in an enteral loop, a band of hyperdensity with net contour. Intraoperative, an extraluminal jejunal tumor was found, located at 15 cm from the duodeno-jejunal flexure, with intraluminal active bleeding, which lead us to suspect a GIST based on the macroscopic aspect. We performed segmental enterectomy of 10 cm of the small intestine containing the tumor with entero-enteral anastomosis end to end. The histopathological and immunohistochemistry examinations correlated with the macroscopic aspect have confirmed the diagnosis of GIST.

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Diagnostic challenges in differentiating intramural gastric abscess from gastric cancer

Cited by 9 publications

References 11 publications

Value of multiphase contrast-enhanced CT with three-dimensional reconstruction in detecting depth of infiltration, lymph node metastasis, and extramural vascular invasion of gastric cancer

Value of multiphase contrast-enhanced CT with three-dimensional reconstruction in detecting depth of infiltration, lymph node metastasis, and extramural vascular invasion of gastric cancer

Gastric wall abscess: A case report and literature review

A Rare Form of Presentation of a Small Intestine Gist in the Emergency Department

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