David L. Carr-Locke, MD; Mohammad Bilal; Saima Ambreen, MBBS, FCPS; Qaisar Shehzad, FCPS, MBBS; Mohammad Umar, MBBS, FCPS, FRCP, FACG; Hamama-Tul-Bushra, MBBS, FCPS, FRCP, FACG


March 22, 2011

Clinical Case Presentation

A 12-year-old girl presented with a 6-month history of abdominal pain and vomiting. She also had intermittent episodes of severe epigastric pain. She had 23 episodes of vomiting every day, which was nonbilious and contained food particles. She was anorexic and had lost weight. She had achieved normal developmental milestones. There was a history of displacement of her family from their home in Pakistan following the 2005 earthquake.

Physical Examination

On examination, her height and weight were at the fifth percentile and her physical development was Tanner stage 2. Her abdomen was scaphoid, with a palpable oblong-shaped hard mass in the epigastrium, extending toward the right upper quadrant.

Laboratory and Imaging Studies

Her hemoglobin was 11.7 g/dL. An abdominal x-ray was normal, but an abdominal CT scan showed a markedly distended stomach filled with heterogenous areas mixed with contrast. Contrast was also seen encircling the mass (Figure 1).

Figure 1. CT scan with contrast with visible mass in stomach.


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