A Gastric Calcifying Fibrous Pseudotumor Detected by Transabdominal Ultrasound after Oral Administration of an Echoic Cellulose-Based Gastrointestinal Ultrasound Contrast Agent

Introduction

We report a rare case of gastric calcifying fibrous pseudotumor detected by transabdominal ultrasound. Transabdominal ultrasound after oral administration of an echoic cellulose-based gastrointestinal ultrasound contrast agent (TUS-OCCA) has recently been suggested as a valuable initial screening tool in selected patients for gastric diseases. In our experience, the selected patients should meet all of the following criteria: 1) patients presenting with upper abdominal complaint or just wanting a health check-up; 2) patients refusing or are unable to undergo gastroscopy examinations; 3) patients with a suitable constitution and whose cardia and pylorus can both be visualized on transabdominal ultrasound before oral contrast agent administration. The patients undergoing TUS-OCCA are scanned in different body positions in order to achieve optimal imaging ([Fig. 1]): supine decubitus mainly for scanning cardia; left decubitus mainly for scanning gastric fundus; right decubitus mainly for scanning gastric body and antrum. The commercially available oral contrast agent (50 g per package) (Best; East Asia Medical Products Co, Ltd, China) is reconstituted by adding 500 ml of boiling water to form a homogeneous thin paste. This 500 ml cellulose-based gastrointestinal ultrasound contrast agent is cooled to a suitable temperature and is then administered orally to improve the distension of the stomach.

Fig. 1 Normal sections of stomach demonstrated by TUS-OCCA. a Normal longitudinal section of gastric cardia (white arrow) obtained below the xiphoid process. b Normal oblique section of gastric fundus obtained along the left costal arch. c Normal longitudinal section of gastric body obtained vertical to the left costal arch. d Normal coronary section of gastric angle (black arrow) obtained vertical to the left costal arch. e Normal longitudinal section of gastric antrum obtained vertical to the right costal arch. f Normal section of duodenal bulb (Du) obtained vertical to the right costal arch.

Abb. 1 Normalschnitte des Magens gezeigt mittels TUS-OCCA. a Normaler Längsschnitt der Magencardia (weißer Pfeil) unterhalb des Processus xiphoideus erhalten. b Normaler Schrägschnitt des Magenfundus entlang des linken Rippenbogens erhalten. c Normaler Längsschnitt des Magenkorpus vertikal zum linken Rippenbogen erhalten. d Normaler Koronarschnitt der Magenkurvatur (schwarzer Pfeil) vertikal zum linken Rippenbogen erhalten. e Normaler Längsschnitt des Magenantrums vertikal zum rechten Rippenbogen erhalten. f Normalschnitt des Duodenums (Du) vertikal zum rechten Rippenbogen erhalten.