Helicobacter pylori-associated antral gastritis and ulcer disease: imaging by computed tomography and ultrasound.

Clinical History This 10 year old male presented to the emergency department after several days of progressive epigastric pain, nausea, and vomiting. He was clinically dehydrated and had mild leukocytosis. Abdominal CT was performed on the evening of presentation, revealing circumferential edema in the wall of the gastric antrum (Figure 1). There was a questionable mucosal defect at the posterior wall, raising concern for an ulcer (arrow, Figure 1). Abdominal ultrasound was performed the following day, confirming antral gastritis (Figure 2) and demonstrating a deep mucosal defect in the posterior wall, consistent with an ulcer (Figure 3). Stool assays were positive for H. pylori. The patient was treated with carafate, proton pump inhibitors, and appropriate antibiotics. His symptoms improved rapidly, and within two weeks he had returned to his clinical baseline. The patient remained asymptomatic for three months, after which he was lost to follow-up.