Gastric Diverticulum Misdiagnosed as a Left Adrenal Lesion
We report a case of gastric diverticulum misdiagnosed as a left adrenal lesion on both
ultrasound and CT imaging and later identified on a follow-up CT.
An abdominal CT scan showed a 2.4 cm rounded mass in the area of the left adrenal
gland with densitometric mean values of -7 HU, interpreted as adrenal adenoma.
In the following days the patient underwent a complete endocrinological
evaluation that showed normal findings with normal adrenal function.
ACTH level and urinary catecholamines were both within normal range.
The patient was then discharged and scheduled for a follow-up CT.
After 6 months the patient underwent a second follow-up CT that showed
a little intralesional gas bubble.
CT scan was subsequently repeated after oral administration
of contrast medium (Gastrografin®); the previously described lesion
showed continuity with the gastric wall, contrast medium staining
of the lumen lesion with contextual air bubbles suggestive of gastric diverticulum.
Diagnosis was later confirmed by esophagogastroduodenoscopy.
GDs are the least common diverticula of the gastrointestinal tract.
Diverticula of the gastric antrum, prepyloric or pyloric regions are extremely
rare and usually asymptomatic.
Clinical history may vary from complete absence of symptoms to dyspepsia,
to major upper Gastrointestinal bleeding, making this condition
a diagnostic challenge.
Gastro Open J. 2015; 1(1): 13-14. doi: 10.17140/GOJ-1-104
