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Author Spotlight: Point-of-Care Ultrasound for Gastric Content Assessment and Risk Stratification in Perioperative Care
Published on: September 22, 2023
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Gastric ulcer with liver penetration.
Emanuel Dias1, Hélder Cardoso2, Catarina Costa3
1Gastrenterology, Centro Hospitalar de São João, Portugal.
Revista Espanola De Enfermedades Digestivas
|January 10, 2022
Summary
A refractory gastric ulcer was found to have penetrated the liver, a rare complication. This diagnosis was confirmed during surgery, even when initial biopsies were inconclusive.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Chronic hepatitis C can predispose individuals to gastrointestinal complications.
- Gastric ulcers that are refractory to proton pump inhibitor therapy require thorough investigation.
Observation:
- A 54-year-old male with chronic hepatitis C presented with epigastric discomfort and weight loss.
- Endoscopy revealed a large, non-healing gastric ulcer despite double-dose proton pump inhibitor treatment.
- Surgical exploration noted fibrotic adhesions and an hepatic fragment adherent to the ulcer.
Findings:
- Histopathological examination of the surgical specimen confirmed liver penetration by the gastric ulcer.
- Initial endoscopic biopsies only showed granulation tissue and inflammation, lacking definitive evidence of liver involvement.
Implications:
- Liver penetration is a rare but critical complication of gastric ulcers that should be considered in refractory cases.
- Diagnostic challenges exist when endoscopic biopsies do not reveal the full extent of ulcer complications.
- Surgical intervention may be necessary for diagnosis and management of complex gastric ulcer complications.
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