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Large Gastric Ulcer Associated With Methamphetamine Use

This educational radiology case reviews a contrast-enhanced CT of the abdomen and pelvis in a patient with abdominal pain and a history of methamphetamine use. The study demonstrates marked gastric wall thickening with a large ulcer along the lesser curvature of the stomach. On CT, there is associated inflammatory change in the surrounding fat and a visible defect within the gastric wall consistent with a large gastric ulcer. Stimulant drugs such as methamphetamine and cocaine can cause significant gastrointestinal complications due to catecholamine-mediated vasoconstriction and small-vessel ischemia. Although large vessels may appear normal on imaging, microvascular ischemia can lead to tissue injury, predisposing areas such as the lesser curvature of the stomach to ulcer formation. This case highlights important CT findings and the pathophysiologic mechanisms underlying stimulant-associated gastrointestinal ischemia. This video is intended for radiology residents, medical students, and clinicians learning abdominal imaging. Hashtags: #foamrad #meded #radiology #methamphetamine #radres