Abstract
Abscesses in the gastric wall are extremely rare. As the mucosa remains intact in
most cases, clear differential diagnosis is required in order to distinguish the condition
from the more frequent intramural mesenchymal tumors. Endoscopic ultrasonography provides
a valuable tool for imaging intramural tumors, but this approach does not allow a
definitive assessment of malignancy. We report about two patients with intramural
abscesses in the gastric wall. Endosonography showing eccentric tumors from the gastric
wall in the two patients. The endosonographic image was inhomogenous, the wall layer
structure of the gastric wall was not preserved. A laparotomy was carried out on the
first patient. In the second case, the diagnosis was easy, as pus was emptying from
a small opening in the mucosa, which had already been detected at gastroscopy. Endoscopic
intervention was carried out based on the endosonographic findings. In one patient,
mucosa and submucosa were opened by a needle knife. These cases show that gastric
wall abscesses do not have a typical endoscopic ultrasound appearance. However, endosonography
is an essential method prior to endoscopic interventional therapy.
