Gastric diverticulum simulating an adrenal mass: CT appearance and embryogenesis

Schwartz, Alan N.; Goiney, R C; Graney, DO

doi:10.2214/ajr.146.3.553

Cited by 30 publications

(20 citation statements)

References 2 publications

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“…2 Gastric cardia diverticula may simulate a left adrenal mass; those on the posterior wall could herniate through the dorsal mesentery and fuse with the left posterior body wall. 3 Patients with gastric diverticula are often asymptomatic, although they may present with dyspepsia, vomiting and abdominal pain. Complications such as ulceration, perforation, hemorrhage, torsion and malignancy are uncommon.…”

Section: Discussionmentioning

confidence: 99%

Gastric diverticulum

Mohan

Ananthavadivelu²,

Venkataraman³

2010

Canadian Medical Association Journal

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A 58-year-old man presented with a one-month history of upper abdominal pain and anorexia. There was no history of dysphagia, vomiting, hematemesis, melena, tiredness or jaundice. His complete blood count, renal function and liver enzyme levels were normal, as were the results of ultrasonography of the abdomen. An upper gastrointestinal endoscopic scan showed a diverticulum in the fundus of the stomach (Figure 1). The pain was reproduced by probing the diverticulum with biopsy forceps as well as by insufflating it with air. The patient's symptoms improved after four weeks' therapy with proton pump inhib itors.

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Section: Discussionmentioning

confidence: 99%

Gastric diverticulum

Mohan

Ananthavadivelu²,

Venkataraman³

2010

Canadian Medical Association Journal

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“…When the posterior-body wall and dorsal mesentery fuse, the pancreas is encapsulated within the retroperitoneal region, wherein a diverticulum of the posterior wall of the gastric cardia may be herniated through an area of dorsal mesentery [24,25]. If the migration of diverticulum occurs before renal ascent, the diverticulum could indent Gerota's fascia and stay between the left kidney and the left adrenal gland [10].…”

Section: Discussionmentioning

confidence: 99%

“…CT scans at prone positioning of the patient may be helpful for its diagnosis by forcing gastric air into the diverticulum cavity, leading to formation of an air-fluid level [20]. A gas shadow in a cystic mass suggests infection, necrosis, or some communication with the gastrointestinal tract [10]. Abscess and necrotic tumor commonly have a thick or shaggy wall while a thin-walled cystic retroperitoneal mass may occur with pancreatitis or gastric ulcer disease.…”

Section: Discussionmentioning

confidence: 99%

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Gastric Diverticulum Simulating Left Adrenal Incidentaloma in a Hypertensive Patient

et al. 2007

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Abstract.A 46-year-old Japanese male with hypertension was referred for examination of left adrenal tumor incidentally detected by computed tomography (CT) scan. The patient had a 4-month history of hypertension. Abdominal CT demonstrated a low-density mass 2.5 cm in diameter in the left adrenal region that was observed as a high-intense lesion with T2-weighted magnetic resonance imaging. 131 I-adosterol scintigraphy showed normal uptake of bilateral adrenals. The adrenocortical hormone levels were within normal ranges; however, urinary noradrenaline excretion was slightly elevated, likely due to concurrent sleep apnea syndrome. Based on the observation of a very tiny bubble in the ventral portion of the adrenal mass by careful review of CT images examined at a previous hospital, a restudy of abdominal CT with oral contrast was performed. In this restudy abdominal CT we observed positive enhancement of the left adrenal mass, indicating that the adrenal mass was a diverticulum derived from posterior gastric fornix. The present case study reinforces that preoperative differentiation from mimic adrenal tumors is necessary in cases of cystic adrenal mass in the left adrenal region.

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“…Conducting scans with the patient in a prone position may further aid diagnosis, by forcing gastric air into the diverticulum cavity, leading to the formation of an air-fluid level in the mass (6). However, sole reliance on CT imaging has been demonstrated to lead to the misdiagnosis of gastric diverticula as adrenal tumors (7)(8)(9)(10)(11)(12)(13)(14)(15). The current study reports the case of a 49-year-old male patient whose initial abdominal CT scan indicated the presence of an adrenal mass.…”

Section: Introductionmentioning

confidence: 99%

Gastric diverticulum simulating a left adrenal mass: A case report and review of the literature

Feng

Zhang

2015

Oncology Letters

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Abstract. Gastric diverticulum (GD) is a pouch protruding from the gastric wall. It is rare and in the majority of cases, asymptomatic. Usually GDs are detected incidentally by gastrointestinal study. The current study reports one case and a literature review of GD mimicking an adrenal mass. A 49-year-old male presented with a low-density lesion in the left adrenal area, but no symptoms of an adrenal adenoma. The lesion was identified as a gastric diverticulum in the fundus of the stomach following enhancement of computed tomography (CT) imaging using an oral contrast agent. Although the majority of previously reported cases utilized upper gastrointestinal barium studies to confirm the presence of GD, the current study demonstrated that CT scanning enhanced with oral contrast material may aid in the differentiation of adrenal masses from other gastrointestinal abnormalities.

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Gastric diverticulum simulating an adrenal mass: CT appearance and embryogenesis

Cited by 30 publications

References 2 publications

Gastric diverticulum

Gastric diverticulum

Gastric Diverticulum Simulating Left Adrenal Incidentaloma in a Hypertensive Patient

Gastric diverticulum simulating a left adrenal mass: A case report and review of the literature

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