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We report a case of benign gastric ulcer with secondary extensive intramural hemorrhage causing a radiographic appearance consistent with a large ulcerated gastric neoplasm. This is the second such case reported and the first studied with sonography and computed tomographic scan. A brief review of the literature on intramural gastric hematoma is presented.

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Rhabdomyosarcoma originating in the biliary tract in children is a rare but distinctive tumor. In a series of 252 primary malignant liver tumors in children, there were only six biliary rhabdomyosarcomas.' A case report that demonstrates the findings on ultrasound examination in such a patient is presented. CASE REPORTA 3-year-old male presented in July, 1984, with a 3-week history of fever, light-colored stools, and jaundice. Physical examination revealed an irritable, jaundiced child with a distended abdomen. Scleral icterus and hepatomegaly were present. The patient was seronegative for hepatitis antigens. Total bilirubin was 10.6 mg/ml with a conjugated fraction of 6.1 mg/ml. The SGOT and SGPT were 79 IU/L and 210 IU/L respectively. The alkaline phosphatase was 2642 U. An ultrasound examination (Fig. 1) demonstrated a 5 x 7 cm irregularly marginated predominantly solid mass involving the porta hepatis and right lobe of the liver. Areas of echolucency were identified within the mass consistent with cystic degeneration or necrosis. The gallbladder was enlarged. Hepatic arteriography revealed a large avascular mass displacing the extrahepatic portion of the common hepatic artery cephalad.A firm, nodular mass was identified in the porta hepatis at laparotomy with proximal dilatation of the common bile duct (28 mm). The gallbladder was removed en bloc with a large mass of tumor. Multiple small nodular tumor masses involving the omentum were identified. Histologic diagnosis was embryonal botryoid rhabdomyosarcoma arising from the cystic duct.

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