Double the Trouble: A Rare Finding of Gastritis Cystica Profunda in a Previously Unoperated Young Female with Concomitant Helicobacter Pylori Infection.

Gastritis cystica profunda (GCP) is a rare lesion of the stomach. It is characterised by hyperplasia and cystic dilation of the gastric gland in the submucosal layer. It is usually believed to occur at the site of previous gastric surgeries, as the anastomotic remnants act as a foundation for the development of the lesion. We present a case of a 39-year-old female, previously healthy with no history of gastric surgeries, who sought medical care for melena and lethargy of one month's duration. Her complete blood count showed a significant drop in haemoglobin (from 13 to 9 g/dl). Upper endoscopy revealed a submucosal lesion in the pre-pyloric region; biopsies showed the characteristic findings of GCP. The latter is a rare cause of upper gastrointestinal (GI) bleeding and its diagnosis and treatment remain challenging. Medical literature has not unveiled its association with chronic inflammation and Helicobacter pylori infection as many cases are being found in previously unoperated individuals. Even though GCP remains a rare entity, it should be incorporated in the differential diagnoses of upper GI bleeding and further prospective studies should highlight other contributing factors.

Learning points: Gastritis cystica profunda (GCP) is a rare lesion of the stomach.GCP is seldom included in the differential diagnosis of an upper GI bleed.GCP can be considered as a premalignant lesion or can portend an underlying malignancy.