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Search Patient Charts: Gastric

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Search Results for => Gastric <= Result Items 1 - 20

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Case ID: 13505 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Gastric outlet obstruction from pyloric stenosis as result of anti-inflammatory induced peptic ulcers
	History	High NG tube output; history of multiple sclerosis, Crohn, on anti-inflammatories.
	Findings	Abdominal Radiographs: Paucity of abdominal bowel gas; nonspecific air-fluid level right upper quadrant CT coronal reconstruction: numerous pills in the stomach
	Differential Dx	Gastric dysmotility Gastric outlet obstruction (malignancy, peptic ulcer disease, Crohn)
	Discussion	... (continues ...)
	User Group
	Contributor	David Heltzel :: National Capital Consortium -
	Reviewer	Maya Sahajwalla :: National Naval Medical Center Bethesda - Case Accepted: 2010-04-14 08:03:55-04 :: Revised: :: Submitted:

Case ID: 13493 Sample Image Click to View	:: - TF Case :: - Thumbnails :: No Topic ::


	Diagnosis	Gastric outlet obstruction from benign ulcer
	History	This 64 y.o. woman has a 4 day history of increasing frequency of vomiting and increasing abdominal distension. She has had 3-4 weeks of intermittent nausea and vomiting during rehab for joint replacement Her vomiting increased over the last 4 days to a maximum 12 times in the last 24 hrs PMH: Crohn’s disease, MS, Bladder CA, GERD, Osteoporosis Surgeries: Cholecystectomy, R knee replacement x 2 (infected)
	Findings	AThere is a constricting lesion present in the pylorus with proximal distension of an atonic stomach full of a large number of retained pills and fluid. A nasoGastric tube is in place within the stomach. There are surgical clips from her prior cholecystectomy.
	Differential Dx	• Gastroenteritis • Gastric outlet obstruction • Gastric bezoar • Gastroparesis
	Discussion	... (continues ...)
	User Group
	Contributor	Mary Teresa M O'Donnell :: Uniformed Services University -
	Reviewer	James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2010-04-14 08:03:55-04 :: Revised: :: Submitted:

Case ID: 13365 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Penetrating Gastric ulcer (into pancreas) Helicobacter pylori gastritis
	History	This is a 13 y.o. boy with recurrent iron deficiency anemia since age four years, managed with chronic iron supplementation. Recent recurrence of anemia in the last 6 weeks accompanied by epiGastric pain, and several episodes of emesis. Two episodes of vomiting contained blood (hematemesis).
	Findings	Abdominal ultrasound: Hypoechoic heterogeneous mass in the head of the pancreas extending along the body of the pancreas with reactive lymph nodes anterior to the pancreas head. Abdominal CT with contrast: Enlarged pancreatic head with edema at the junction of the head and body and disruption anteriorly. Marked Gastric wall thickening and distention with a collection of fluid along the posterior stomach wall.
	Differential Dx	• Ulcer disease (H. pylori vs hyperacidity) • Trauma with pancreatic laceration • Walled-off perforation • Pancreatic pseudocyst • Pancreatitis
	Discussion	... (continues ...)
	User Group
	Contributor	Lindsay M Stollings :: Childrens Hospital of Dayton, OH -
	Reviewer	Dawn E Light :: Childrens Hospital of Dayton, OH - Case Accepted: 2010-04-14 08:03:55-04 :: Revised: :: Submitted:

Case ID: 13288 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Pre-pyloric Gastric perforation, cocaine abuse
	History	19 y.o. man who presents w/ six hours of severe epiGastric and upper abdominal pain, radiating to his back. He volunteered that he had been smoking cocaine (crack) one hour prior to the start of his symptoms. Social history is positive for EtOH (six drinks daily), tobacco, and cocaine abuse. He has no prior medical or surgical history and no previous abdominal complaints.
	Findings	Single AP supine view of abdomen demonstrates a thin line of gas in the right upper quadrant, concerning for free air. Mildly distended prominent centralized loops of small bowel are seen in the mid abdomen which may represent a regional ileus. Gas is seen outlining the left psoas muscle. Single AP frontal view of chest demonstrates a subtle area of lucency under the right hemidiaphragm suspicious for free air in the abdomen. No pneumothorax is noted.
	Differential Dx	Abdominal free-air: • Perforated hollow viscus (eg. Gastric - peptic ulcer disease) • Ischemic enteritis • Pneumomediastinum/pneumothorax decompressing into abdomen • Gas-forming bacterial peritonitis • Penetrating trauma to abdomen
	Discussion	... (continues ...)
	User Group
	Contributor	Sonja I Parisek :: Affiliation Unlisted - Please See Comments -
	Reviewer	Robert A Jesinger M.D. :: David Grant USAF Medical Center - Case Accepted: 2010-04-14 08:03:55-04 :: Revised: :: Submitted:

Case ID: 13172 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Gastric MALT Lymphoma, poorly differentiated
	History	75 y/o man with a history of chronic active gastritis and refractory Gastric ulcer. A 6 cm by 6 cm Gastric mass found on esophagogastroduodenoscopy (EGD).
	Findings	•A long segment of the Gastric wall lesser curvature is asymmetrically thickened to 23mm. The fat plane between the liver and the stomach appears to be preserved. •Additional findings not shown in selected image: A 9 mm lymph node is present between the stomach and the liver. An 11mm pancreatic node is seen. • The liver, spleen, gallbladder, pancreas, and adrenal glands are unremarkable. A 3.2 cm simple cyst is seen in the superior pole of the right kidney. The left kidney is unremarkable.
	Differential Dx	• Adenocarcinoma • Gastric lymphoma • Metastatic disease • Gastritis
	Discussion	... (continues ...)
	User Group
	Contributor	Nicolas B Moya del Pino :: - Leave Blank - -
	Reviewer	Rachel Booth Lewis :: National Naval Medical Center Bethesda - Case Accepted: 2010-04-14 08:03:55-04 :: Revised: :: Submitted:

Case ID: 13114 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Gastric Volvulus
	History	12 month old male presents to the ER with his mom with abdominal distention and pain, nonbilious vomiting, and listlessness.
	Findings	-AP radiograph of the abdomen demonstrates marked Gastric distention. No air is seen distally. -Spot image from an upper GI examination demonstrates an nasoGastric tube in the stomach. The stomach is rotated such that the Gastric fundus is located inferior to the pylorus.
	Differential Dx	Mesenteroaxial Gastric Volvulus
	Discussion	... (continues ...)
	User Group
	Contributor	Michael V Huppmann :: Walter Reed Army Medical Center -
	Reviewer	William R Carter, M.D. :: National Naval Medical Center Bethesda - Case Accepted: 2010-04-14 08:03:55-04 :: Revised: :: Submitted:

Case ID: 12930 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Gastric Trichobezoar
	History	Anxious girl complaining of upper abdominal pain
	Findings	Single frontal radiograph image of the upper abdomen after barium ingestion as part of a fluoroscopic UGI examination demonstrates a large filling defect within the stomach.
	Differential Dx	Gastric Carcinoma Hematoma Giant Polyp Bezoar
	Discussion	... (continues ...)
	User Group
	Contributor	James Odone MD :: David Grant USAF Medical Center -
	Reviewer	Robert A Jesinger M.D. :: David Grant USAF Medical Center - Case Accepted: 2010-04-14 08:03:55-04 :: Revised: :: Submitted:

Case ID: 12451 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Gastric trichobezoar
	History	A 28 year old woman presented with chronic right upper quadrant and epiGastric addominal pain, decreased appetite, and a palpable epiGastric mass for five months.
	Findings	A right upper quadrant ultrasound was performed. Evaluation of the liver, gallbladder, pancreas, and right kidney was normal. Ultrasound of the area of palpable abnormality inferior to the liver revealed an echogenic image with curvilinear dense hyperechogenic surface and dense posterior shadowing. A CT of the abdomen and pelvis with oral and intravenous contrast reveals a markedly enlarged stomach distended by a round intraluminal mass of hypointense heterogeneous material. Retained air is visualized in the interstices. A thin rim of hyperintense material is seen lining the stomach wall representing displaced oral contrast.
	Differential Dx	- Trichobezoar - trichophytobezoar - Phytobezoar - soft tissue tumor - Gastric outlet obstruction - Gastric or colonic dilatation by fluid - A heavily calcified abdominal or Gastric mass - impacted fecal mass - Large quantities of ingested food such as dried pasta or cereal
	Discussion	... (continues ...)
	User Group
	Contributor	Aaron B Wickley :: Affiliation Unlisted - Please See Comments -
	Reviewer	James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2010-04-14 08:03:55-04 :: Revised: :: Submitted:

Case ID: 12123 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Gastric Lymphoma
	History	48 y.o. man with presenting complaint of vomiting after eating.
	Findings	Fluoroscopic images show a large filling defect consistent with a mass in the distal body and antrum of the stomach with significantly delayed passage of contrast. Esophagogastroduodenoscopy (EGD) images show diffuse wall thickening and luminal narrowing secondary to an infiltrating process.
	Differential Dx	•Adenocarinoma •GI stromal tumor •Lymphoma •Bezoar causing obstruction.
	Discussion	... (continues ...)
	User Group
	Contributor	Robert A Liotta :: National Capital Consortium -
	Reviewer	James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2010-04-14 08:03:55-04 :: Revised: :: Submitted:

Case ID: 11448 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	BORDERLINE NORMAL Gastric EMPTYING
	History	43 year-old male status post laparoscopic cholecystectomy with a bloated feeling. Please perform Gastric emptying study to evaluate Gastric transit. UGI series performed 2 years prior notable only for a small hiatal hernia with a moderate gastroesophageal reflux.
	Findings	The stomach appears usual in shape and orientation (anterior images are displayed only). Following a lag phase of 10 minutes, the stomach empties progressively at a constant rate with a calculated one-half Gastric emptying time of 89 minutes (normal is 45 to 90 minutes), which corresponds with the visual estimate. No gastroesophageal reflux is observed throughout the study, and anterograde movement of radiolabelled meal throughout the intestine appears normal. Following intravenous injection of metoclopramide (Reglan), Gastric emptying accelerates with a calculated one-half Gastric emptying time of 7 minutes.
	Differential Dx	N/A
	Discussion	... (continues ...)
	User Group
	Contributor	Sun Y Kim :: Walter Reed Army Medical Center -
	Reviewer	Sun Y Kim :: Walter Reed Army Medical Center - Case Accepted: 2010-04-14 08:03:55-04 :: Revised: :: Submitted:

Case ID: 11180 Sample Image Click to View	:: - TF Case :: - Thumbnails :: No Topic ::


	Diagnosis	Adenocarcinoma of Gastric Antrum
	History	54yo caucasian male with 3 month history of progressive early satiety, post prandial vomiting and anorexia. Patient reported weight loss in excess of 15 pounds during previous 1 month. Patient has an 80 pack year history of smoking and 25 year history of heavy alcohol ingestion.
	Findings	An abdominal CT with contrast was obtained. A. Although this is an abdominal CT with contrast, note the sequestration of contrast material in the stomach secondary to complete Gastric outlet obstruction. There is a 2 cm mass posterior to the stomach in the vicinity of the antrum. There is a cleavage plane between the mass and the head of the pancreas which suggests a Gastric etiology. There is a large infarct in the right lobe of the liver, most likely secondary to right portal vein thrombosis. B. 2cm Gastric mass can be seen. Omental caking is indicative of carcinomatosis is seen anterior to the liver. Significant ascites is noted throughout the abdomen. There are multiple hypodensities in both kidneys which appear consistent with a cystic etiology. Adenopathy is present in the periaortic and parapancreatic regions. C. More evidence of omental caking, ascites, renal cysts and marked adenopathy.
	Differential Dx
	Discussion	... (continues ...)
	User Group
	Contributor	Boma O Afiesimama :: Uniformed Services University -
	Reviewer	James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2010-04-14 08:03:55-04 :: Revised: :: Submitted:

Case ID: 11172 Sample Image Click to View	:: - TF Case :: - Thumbnails :: No Topic ::


	Diagnosis	Gastric diverticulum
	History	52yo caucasian female who presents with several day history of epiGastric pain.
	Findings	Films show a barium filled defect in the Gastric mucosa on the greater curvature of the fundus with the crater bottom extending beyond the lumen of the stomach. Films show a pendulous appendage with smooth borders containing residual barium. The mucosal folds appear to end at the ulcer edge. There does not appear to be any heaping of the ulcer edges. There is no adjacent mass. Crater cavity changes shape from film to film.
	Differential Dx	Gastric diverticulum Benign ulcer Gastric cancer Aberrant pancreatic tissue
	Discussion	... (continues ...)
	User Group
	Contributor	Boma O Afiesimama :: Uniformed Services University -
	Reviewer	James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2010-04-14 08:03:55-04 :: Revised: :: Submitted:

Case ID: 11123 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Dieulafoy's lesion: An angiographic finding of a Gastric AVM
	History	A 53 y.o. female with upper GI bleeding refractory to endoscopic band ligation and electrocoagulation was refered to the interventional radiologist for a TIPS procedure. The interventional radiologist, after review of the patient's RUQ ultrasound and laboratory values, elected to perform a mesenteric angiogram rather than a TIPS procedure. Subsequently, she was found to be an extremely poor candidate for surgical or interventional therapy and was followed on a medical basis.
	Findings	Abdominal ultrasound demonstrated normal hepatopedal flow in the portal vein and patent hepatic veins. (No images) A three vessel mesenteric angiographic study revealed abnormal small arteries arising from the short Gastric arteries. These abnormal arteries had multiple direct connections to the Gastric venous plexus. Innumberable abnormal ectatic and aneurysmal submucosal veins were identified in the region of the fundus of the stomach, confirming the endoscopic findings.
	Differential Dx	Budd-Chiari syndrome Cirrhosis Gastritis AVM
	Discussion	... (continues ...)
	User Group
	Contributor	Jonathan S Jewkes :: White Memorial Medical Center -
	Reviewer	Michael John Neglio, MD :: White Memorial Medical Center - Case Accepted: 2010-04-14 08:03:55-04 :: Revised: :: Submitted:

Case ID: 11119 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Gastric diverticulum
	History	55 year old female with history of reflux.
	Findings	Fluoroscopic images demonstrate a smooth outpouching from the fundus of the stomach with contrast pooling in the dependent portion.
	Differential Dx	Gastric diverticulum Gastic ulcer Adenocarcinoma
	Discussion	... (continues ...)
	User Group
	Contributor	Brad L Kocher :: National Capital Consortium -
	Reviewer	Angela Levy, M.D. :: Georgetown University Hospital - Case Accepted: 2010-04-14 08:03:55-04 :: Revised: :: Submitted:

Case ID: 10834 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Gastric trichobezoar, Rapunzel Syndrome
	History	9 year old girl presents with abdominal pain and feeding intolerance.
	Findings	• Plain film shows LUQ mass displacing bowel loops • CT shows concentric rings of air and soft-tissue density
	Differential Dx	• Abscess • Emphysematous gastritis • Gastric phlegmon
	Discussion	... (continues ...)
	User Group
	Contributor	James G. Smirniotopoulos, M.D. :: Uniformed Services University -
	Reviewer	James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2010-04-14 08:03:55-04 :: Revised: :: Submitted:

Case ID: 10223 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Gastric Diverticulum
	History	Abdominal pain.
	Findings	Small oral contrast filled diverticuli off the posterior aspect of the Gastric antrum.
	Differential Dx	Renal mass Adrenal mass
	Discussion	... (continues ...)
	User Group
	Contributor	Erin K Collins :: Naval Medical Center Portsmouth -
	Reviewer	Stephanie A Bernard :: Penn State University - Case Accepted: 2010-04-14 08:03:55-04 :: Revised: :: Submitted:

Case ID: 10092 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Multiple Gastric polyps
	History	55 year old female with history of stomach pains, mainly postprandial.
	Findings	On fluoroscopy there are typically multiple small, less that 1cm, sharply defined masses or filling defects throughout the stomach of similar sizes.
	Differential Dx	Hyperplastic polyps secondary to inflammation (majority) Adenomatous polyps secondary to chronic atrophic gastritis or polyposis syndrome Hamartomas secondary to polyposis syndrome Metastatic disease, often melanoma, breast, or lung
	Discussion	... (continues ...)
	User Group
	Contributor	clark brixey :: National Capital Consortium -
	Reviewer	Angela Levy, M.D. :: Georgetown University Hospital - Case Accepted: 2010-04-14 08:03:55-04 :: Revised: :: Submitted:

Case ID: 9911 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Bilateral pleural effusions, bilateral pelvic hematomas, fracture/tract of left iliac, Left 5th rib fracture, thickening of Gastric wall - non-specific changes, and post surgical changes to left upper quadrent status post splenectomy.
	History	25 y/o man with 3 GSW to chest, abdomen, and Left buttock. Pt was resuscitated and had an ex-lap performed before transfer to WRAMC.
	Findings	Chest film: Blunting of CP angles especially on left. Air bronchograms and atelectatic lungs. Positive spine sign. CT: Bilateral pleural effusions with compressive attelectasis L>R. Multiple prominent axillary lymph nodes are identified meeting pathologic criteria in number but not in size. A hypodense band is seen in the upper pole of the left kidney representing laceration. Post surgical changes are noted in the L upper abdomen with 2 metallic clips seen and an absent spleen. Clip is in the L hemidiaphragm status post diaphragmatic rupture. Colostomy is seen on left with descending colon attached. The stomach reveals a thickened and irregular wall with out evidence of a filling defect or focal mass. Two fluid collections are seen in the pelvis, one in the left hemipelvis anterior to the iliac and the second in the right hemipelvis consistent with hematomas. Air can be seen in the left gluteus maximus and in the left lateral wall representing bullet tract. In the bony structures there is a complete fracture through the wing of the left ilia with several bone fragments in the pelvis consistent with the ballistic tract. A fracture is also noted in the middle portion of the left 5th rib from another bullet.
	Differential Dx	PolyTrauma from multiple ballistics
	Discussion	... (continues ...)
	User Group
	Contributor	Brittany L O'Steen :: Uniformed Services University -
	Reviewer	Les R Folio :: Uniformed Services University - Case Accepted: 2010-04-14 08:03:55-04 :: Revised: :: Submitted:

Case ID: 9716 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Hyperplastic Gastric Polyps
	History	37 yo female undergoing upper GI examination for a history of noncardiac substernal chest pressure during eating and positive H. pylori. No family history of GI malignancy.
	Findings	Multiple small, rounded polyps along the Gastric cardia and fundus. There is no evidence of ulceration.
	Differential Dx
	Discussion	... (continues ...)
	User Group
	Contributor	Christin M Brown :: Naval Medical Center Portsmouth -
	Reviewer	Stephanie A Bernard :: Penn State University - Case Accepted: 2010-04-14 08:03:55-04 :: Revised: :: Submitted:

Case ID: 9531 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Gastric diverticulum
	History	46 year old male had a non-contrast CT scan looking for a urolith. An incidental finding was noted, followed by a CT scan with oral contrast.
	Findings	There is a soft tissue mass posterior to the stomach. On the non-contrast images, this does not definitively communicate with the stomach. The CT images with contrast demonstrate filling with the oral contrast, verifying the diagnosis.
	Differential Dx	Gastric diverticulum Accessory spleen Adrenal mass
	Discussion	... (continues ...)
	User Group
	Contributor	James M Grimson :: Naval Medical Center Portsmouth -
	Reviewer	Stephanie A Bernard :: Penn State University - Case Accepted: 2010-04-14 08:03:55-04 :: Revised: :: Submitted:

63 Search Results for => Gastric <= Result Items 1 - 20

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