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Abdomen » Gastrointestinal
Carcinoma of the pylorus with intramural infiltration
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This 34 year lady was suffering from anemia (Hb : 5-6gm%) of undiagnosed etiology since last one and half years. She was sent for USG of abdomen due to recent onset of pain in the epigastric region. The USG of abdomen was done in our institute.

Caption: Transverse image of epigastric region
Description: A target type lesion is seen just anterior to and right of the head of the pancreas
Caption: Image of the gall bladder area
Description: The lesion seen just medial to the GB fossa
Caption: Oblique view in right side of epigastric region
Description: Grossly thick walled pylorus seen arising from the stomach
Caption: Multiplanar 3D view of ROI
Description: Thick and long pylorus appreciated in all 3 perpendicular planes.
Caption: Transverse view of the lesion by high frequency linear transducer
Description: All the layers of pylorus especially the muscularis propria (9mm) and submucosa (4-5mm) are appreciably thick
Caption: Longitudinal details of the lesion
Description: All the layers of this 5cm long tubal structure arising from stomach are thickened. However the gut signature seems to be maintained. This diffuse thickening of the pylorus is likely due to intramural infiltration
Differential Diagnosis Carcinoma of pylorus
Thickened pyloric wall due to chronic inflammatory condition(Crohn’s disease) .
Carcinoma of stomach with pyloric infiltration.
Final Diagnosis Carcinoma of the pylorus with intramural infiltration
Discussion Chronic anemia in this case is likely due to the pyloric carcinoma preventing iron absorption.
Technical Details Sonoace-R7 by Samsung. The transducers used convex 2-8mhz. Volume convex2-6mhz, Linear 5-12mhz.
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