PMC6416965_01
Coronal view of abdominal CT scan with IV contrast showing massive splenomegaly with query indentation of upper part of the stomach.
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Tomography (CT) Scan of the abdomen showed massive splenomegaly with splenic infarction and possible superimposed infection (Fig. 1).
Endoscopic picture of the stomach showing edematous folds with query fistula opening in the funds area.
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Prior to surgery, he had an episode of vomiting which was thought to be coffee-ground vomitus; accordingly, upper GI endoscopy was done and the edematous gastric mucosa in the fundus was misinterpreted as large gastric varices at the time of the study (Fig. 2).
Gross picture of the spleen after removal, showing huge abscess cavity.
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The fistula was managed by partial gastrectomy (Fig. 3).
Contrast meal study demonstrates no leak in the gastric surgical site.
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Three days post-operative, contrast meal study was done which demonstrated no leak at the surgical site (Fig. 4).