J Korean Med Sci.  2012 May;27(5):569-571. 10.3346/jkms.2012.27.5.569.

Pseudotumor of the Omentum Associated with Migration of the Ingested Crab-Leg

• Cho HJ
• Kim SJ
• Lee SW
• Moon SW
• Park JH

• KMID: 1372804
• DOI: http://doi.org/10.3346/jkms.2012.27.5.569

Abstract

Foreign body ingestion is not uncommon in clinical practice, and it may occasionally lead to penetration injuries. Emergency physicians and radiologists sometimes fail to obtain complete histories including ingestion and may overlook the possibility of foreign body-induced complications. Herein, we report a case of stomach antrum perforation due to foreign body migration. We were unaware of the patient's history of eating the Korean delicacy "Kanjang-gaejang," which is raw crab seasoned with soy sauce. Several imaging diagnostic modalities had suggested the possibility of a malignant mass in the gastrocolic ligament area. During the operation, a crab leg was discovered as the cause of an intra-abdominal abscess. The patient underwent an antrectomy, a vagotomay, and a transverse colon wedge resection. We present this unusual case of a pseudotumorous lesion caused by ingestion of Kanjang-gaejang.

Keyword

Foreign Bodies; Crab; Perforation; Stomach; Pseudotumor

MeSH Terms

Abscess/microbiology
Endoscopy, Digestive System
Foreign-Body Migration/*radiography/ultrasonography
Humans
Male
Middle Aged
Omentum/*radiography/ultrasonography
Positron-Emission Tomography
Pyloric Antrum/radiography
Rupture
Stomach/injuries
Streptococcus/isolation & purification
Tomography, X-Ray Computed

Figure

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  Fig. 1 Abdominal computed tomography findings of the case. Pre-contrast CT (A), post-contrast CT (B), and coronal view (C) showing ill-defined heterogeneous hypodense mass in the gastrocolic ligament with perilesional omental infiltration. Thickening gastric antral wall is also shown. The migrated crab leg which was mistaken for enhancing vascular structure (arrow).

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  Fig. 2 Upper abdominal sonographic finding: 9 cm heterogeneous echogenic mass lesion showing mild blood flow in the omentum of the right upper abdominal quadrant.

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  Fig. 3 Gross view of the resected pseudotumor. (A) Resected gastric colic ligament including mass lesion. (B) Crab leg was found in the abscess cavity.

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