PMC5655411_01
Axial view of CT abdomen/pelvis with IV contrast demonstrating a bulky circumferential irregular thickening and enhancement of the gastric wall at the level of the pylorus involving the duodenal bulb. Additionally, there is a chronic ellipsoid pocket of fluid associated with the peritoneal lining posterior to the liver that was noted to represent an old abscess or hematoma cavity.
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The CT demonstrated bulky, circumferential and irregular thickening and enhancement of the gastric wall at the level of the pylorus, involving the duodenal bulb (Fig. 1).
(A) cross section of the stomach with the incarcerated gallstone lodged within the wall. (B) image with the gallstone removed showing the cavity in the wall (red box denotes the area that was sampled in the histologic sections). (C) Low power photomicrograph (scale bar = 5 mm) showing the cavity in the wall with the overlying gastric mucosa. (D) High power photomicrograph (scale bar = 50 mum) showing mixed acute and chronic inflammation within the wall of the stomach.
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A single calcified stone measuring 0.6 cm in diameter was identified incarcerated within the wall of the pylorus (Fig. 2A-B). Histologic sections from the gastric wall with the incarcerated stone (Fig. 2C-D) showed dense inflammation centered in the submucosa emanating from the cavity formed by the incarcerated stone.