Background: Fever and abdominal pain are common symptoms with many possible differential diagnoses.
Case presentation: An otherwise healthy man in his twenties was admitted to hospital with fever and epigastric pain. On admission he was febrile. The physical examination revealed nothing abnormal except epigastric tenderness. Laboratory data showed elevated white blood cell count and C-reactive protein level. Abdominal CT scan demonstrated a large mass in the gastric antrum. The patient underwent upper endoscopy revealing a submucosal tumour-like expansion. Puncture of the mass resulted in drainage of pus, and biopsies additionally confirmed the diagnosis of gastric wall abscess. Follow-up scans eight weeks after drainage showed complete resolution.
Interpretation: Gastric wall abscess is a rare but important differential diagnosis in patients presenting with fever and abdominal pain. As shown, the condition can also occur in younger patients without any known risk factors.