Presentation
Female with upper abdominal discomfort and loss of appetite.
Patient Data
Symmetrical diffuse thickening of the pylorus extending into the duodenum to the D1-D2 junction.
The stomach is distended down to the pylorus in keeping with a degree of gastric outlet obstruction.
No locoregional lymphadenopathy.
Small splenic lesion, likely a cyst.
No peritoneal nodules.
Case Discussion
This case illustrates the value of the use of water (a negative contrast agent) rather than positive oral contrast agents in CT.
The patient is also scanned sooner than with standard oral preparation whilst the water remains in the stomach, in so doing distending the stomach and outlining the wall and mucosa more effectively.
In this case a degree of gastric outlet obstruction from the pylo-duodenal tumor has also made the tumor better illustrated.
Endoscopy biopsy was one of gastric adenocarcinoma.
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