The gastric wall in this patient revealed a focal 0.6 cm, hypoechoic thickening. This impinges upon the lumen. Intraoperative ultrasound and full thickness biopsies are strongly recommended of this lesion as it meets neoplastic criteria whereas the remainder of the pyloric outflow and stomach maintain curvilinear patterns. The region of the pyloric thickening measured 2.3 x 0.82 cm. Variable small intestinal thickening was noted elsewhere with hypertrophied muscularis without loss of mural detail. Minor reactive mesentery was noted. Regional lymph node enlargement was also present and would necessitate full thickness biopsies for definition. These are adjacent to the focal, pyloric thickening.

The liver was slightly hypoechoic and mildly enlarged. The gallbladder presented thin walls with normal, primarily anechoic content. The cystic and common bile ducts were normal. No pathological hepatic lymphadenopathy was evident. No overt structural evidence of inflammatory, infiltrative or regenerative pathology was noted.

The right and left limbs, as well as the base of the pancreas were observed to be largely isoechoic to surrounding omental fat. No overt evidence of acute active inflammatory or neoplastic disease was noted. Some parenchymal remodeling, however, with mild deviation from curvilinear normalcy was observed. Pancreatic duct and capsular irregularities were present consistent with age related changes. The pancreatic duct was dilated at 0.38 cm.