Perforation of Gastric Ulcer into the Giant Cyst of the Liver: Report of a Case

Atsushi Ishibe, Hideyuki Ike, Yukihiko Hiroshima, Kenichi Matuzu, Yoshihiro Suzuki, Haruhiko Chou, Takashi Chishima, Yasunobu Yamazaki, Takashi Suda and Hiroshi Shimada*

Department of Surgery, Saiseikai Yokohama Nanbu Hospital
Department of Gastroenterological Surgery, Yokohama City University, Graduate School Medicine*

We reported an extremely rare case of a gastric ulcer perforating into a cyst. A 78-year-old man seen in December 2005 for severe epigastralgia was found in plain computed tomography (CT) to have a giant liver cyst containing gas. Laparotomy showed the stomach had adhered to the cyst. This and the presence of a gastrocystic fistula yielded a diagnosis of gastric ulcer perforation into a liver cyst with localized peritonitis. Using a surgical stapler, we transected the cyst wall from the stomach and drained the cyst. Proton pump inhibitor was administered postoperatively for an active ulcer in the lesser curvature of the gastric body. Pathological findings showed no malignancy. The man was discharged following a smooth postoperative course. The definitive diagnosis was gastric ulcer perforating into a liver cyst. The man remains well without liver cyst recurrence in the half year since surgery.

Key words
gastric ulcer, giant liver cyst, perforation

Reprint requests
Atsushi Ishibe Department of Gastroenterological Surgery, Yokohama City University, Graduate School Medicine
3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004 JAPAN

Accepted
November 22, 2006

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