Unusual cause of a giant antral ulcer

Clinical presentation A 31-year-old man visited our gastroenterology clinic owing to continuous epigastric pain lasting 3 months, diarrhoea during the previous month and an associated 10 kg weight loss. An ulcer in his antrum was discovered by oesophagogastroduodenoscopy (EGD), and he took a proton-pump inhibitor for a month. However, his clinical symptoms and ulcer worsened. He denied melena, haematemesis, fever, arthralgia, recurrent aphthous ulcer and genital ulcer. He had a >10-year history of asthma and eczema. Physical examination was unremarkable except for emaciation and upper abdominal tenderness. Laboratory test results were normal, including routine stool studies, serum amylase measurement, liver function tests, tumour marker measurements, 14C-urea breath test and parasite tests. A remarkable EGD finding was a giant ulcer in the antrum (figure 1A). Colonoscopy showed multiple shallow ulcers (0.2–0.4 cm) throughout the colon (figure 1B). Contrast-enhanced CT showed a markedly thickened gallbladder wall, with a...
Source: Gut - Category: Gastroenterology Authors: Tags: GUT Snapshot Editor ' s quiz: GI snapshot Source Type: research