The transverse image of the stomach reveals marked focal thickening of the gastric wall extending from the ventral surface to the lesser curvature. The affected gastric wall is hypoechoic and lacks wall layering. The echogenic wedge-shaped foci noted in the near field within the thickened gastric wall may represent an area of necrosis or fibrosis. Video: Loss of detail is noted in the affected pyloric outflow tract meeting neoplastic criteria but complicated inflammatory disease may present occasionally in this manner. The lesion is focal and may be resectable.