A 34-year-old male was admitted with "pain in the upper abdomen for 1 d". Physical examination: The upper abdomen, especially the left upper abdomen, showed obvious tenderness, no rebound pain and abdominal muscle tension, and no obvious mass was palpable. Gastroscopy showed a huge bulge in the gastric cavity, which was purple-red, covered with white coating and blood stains. The gastric cavity was significantly narrowed, and the inversion of the mirror body was difficult. After the inversion, the gastric fundus, cardia and gastric body could not be observed. CT plain scan showed a huge slightly high-density space in the gastric cavity, the CT value was about 63 HU, the density was uneven, the maximum cross-sectional area was about 17.6 cm ×10.5 cm, the lateral gastric wall was thickened and rough, and a spotty high-density shadow was seen in the local gastric wall. No obvious enhancement of the intragastric space was found on enhanced scan (Figures 1~3), and no obvious enlarged lymph nodes were found around the stomach and after the peritoneum. Surgical exploration showed that a cystic mass with a long diameter of about 18 cm could be palpable in the fundus of the stomach. Due to the dense adhesion of the surrounding tissues, the serosa of the posterior wall of the stomach ruptured during the separation process, and an old blood clot flowed out. A fish bone about 1.0 cm ×0.5 cm ×0.3 cm in size was seen in the stomach wall, which was spiny. The fish bone was removed, the hematoma was aspirated, and a 3 cm long incision was opened on the anterior wall of the large curvature of the stomach. The inner wall of the stomach was obviously swollen, and the bottom of the stomach seemed to be damaged. It was considered that it was caused by bleeding in the stomach wall caused by fish bone.
