An Unexpected Image on Plain Radiograph in a Child with Abdominal Complaints: A Case Report

Plain radiography is a useful tool for distinguishing many intraabdominal pathologies and it rarely leads to a surprising diagnosis. Here, present a 12-year-old girl who presented with abdominal discomfort, dull pain and tenderness on palpation in the right upper quadrant, epigastrium and the right flank. Plain radiography showed an opacification due to gastric wall thickening. She was diagnosed with gastric ulcer, erosive gastropathy and duodenal ulcer based on findings of endoscopic examination. Her NSAID medication was ceased, and she was commenced on proton pump inhibitor. Her symptoms and radiological and endoscopic findings improved after two months of treatment. Gastric wall thickening seen on plain radiography as an opacified area is a rare evidence of peptic ulcer in children and may guide to choose endoscopy first instead of other modalities involving exposure to ionising radiation in further evaluation.