Lesions of the Upper Gastrointestinal Tract Identified on Routine Transabdominal Ultrasonography

Recent technical advances and the increasing use of ultrasonography in the evaluation of patients with upper abdominal pain, along with careful attention and effort during ultrasonographic examination, have increased the detection rate of unexpected lesions in the upper gastrointestinal tract. The purpose of this pictorial review is to demonstrate the ultrasonographic findings of various lesions involving the stomach and duodenum, detected during routine transabdominal ultrasonography without ingestion of water. In the study, the ultrasonographic findings are correlated with comparative studies of gastroscopy, CT, endoscopic ultrasonography, and barium studies of the upper gastrointestinal tract.

Neonatal Gastric Web Located in the Body of Stomach: A Case Report

Gastric web is a rare gastric anomaly and almost all the reported cases have been located in the distal antrum. We experienced a case of neonatal gastric web that was located in the body of stomach, and we report the findings of the upper gastrointestinal series and ultrasonography.

The Usefulness of the Transabdominal Ultrasonography as a Screening Examination in the Evaluation of the Patient with Suspicious Gastric Disease

PURPOSE: To evaluate the usefulness of transabdominal ultrasonography as a screening examination in patients with suspicious gastric disease. MATERIALS AND METHODS: We selected 141 patients with epigastric pain and who were found to have antral gastric wall thickening of more than 5 mm in transabdominal ultrasonography, and who underwent gastroscopy immediately following the ultrasonography examination, because we suspected that these patients had gastric disease. We measured the full thickness of the five layers of the gastric wall and evaluated the preservation of this fivelayered structure. We respectively compared the gastric wall thickness and the preservation of gastric layers in 26 normal, 91 gastritis, 12 gastric ulcer, and 12 gastric cancer patients, who were classified based on the gastroscopy results. RESULTS: The mean thicknesses of the gastric wall in the normal, gastritis, gastric ulcer and gastric cancer patients were 5.13+/-0.14 mm, 6.71+/-1.33 mm, 8.08+/-2.80 mm, and 12.45+/-3.70 mm, respectively. The gastric walls in the gastritis, gastric ulcer and gastric cancer patients were significantly thicker than that in the normal patients (p 0.01). Except for two patients with gastritis and three patients with gastric ulcer, the stratification of the gastric wall was preserved in all of the normal, gastritis and gastric ulcer patients, whereas it was disrupted in all of the patients with gastric cancer. CONCLUSION: Transabdominal ultrasonography in the fasting state may be a helpful and convenient modality, which can serve as a screening examination in the evaluation of gastric disease. Therefore, careful attention and effort are needed to evaluate the gastric wall during transabdominal ultrasonography.

Recurrent Pediatric Mesenteroaxial Gastric Volvulus: Case Report Focusing on Ultrasonographic and CT Findings

Gastric volvulus is a rare condition, and it is classified as the organoaxial or mesentericaxial type according to the axis of rotation. We experienced 1 case of pediatric recurrent mesenteroaxial gastric volvulus and we report here the ultrasonographic and CT findings.

Assessment of Mural Invasion Depth of Gastric Carcinoma with High-Resolution Compound Sonographic Imaging in Vitro

PURPOSE: To evaluate whether the accuracy of invasion depth assessment in gastric carcinoma in vitro can be improved with high-resolution spatial compound sonographic imaging. MATERIALS AND METHODS: In sixteen fresh gastric specimens obtained from patients with preoperatively biopsyproven gastric carcinoma, normal and lesional areas were scanned using conventional and compound imaging technique with a 15-MHz linear transducer. Two radiologists independently compared the sharpness and the contrast of images obtained with two different modes and determined the layers invaded by cancer with consensus. The invasion depths by images were compared with histopathologic results. RESULTS: The sharpness and the contrast in normal and lesional areas were significantly higher in compound imaging (p0.05). CONCLUSION: High-resolution spatial compound sonographic imaging has improved image quality, compared with conventional imaging, but the accuracy of invasion depth assessment in gastric carcinoma was not significantly different.

Cystic Lesions in the Stomach

Cystic lesions of the stomach are rare and usually detected incidentally during surgery or autopsy. Amongseven cases of cystic masses, duplication cysts accounted for four, retension cysts of ectopic pancreas for two,and cystic lymphangioma remaining one. In the upper gastrointestinal series, all were submucosally, whileendoscopic ultrasonography showed that the location of cystic masses was also submucosal. Except for two cases ofduplication cyst and cystic lymphangioma which were thin-walled, lesions were well-defined and showed lowattenuation. In addition, abdominal CT scanning showed two cases of retension cyst of ectopic pancreas.

Radiologic Finding of Gastric Antral Vascular Ectasia: A Case Report

Gastric antral vascular ectasia ("watermelon stomach") is characterized by a prominent longitudinalerythematous fold of gastric antrum. Because it has usually been diagnosed by gastroscopy and biopsy, itsradiologic findings have not been well described. We report a case of gastric antral vascular ectasia, anddescribe its findings, as seen on UGIS, ultrasonography, and computed tomography.

Comparison of Radiologic and Pathologic Findings of Gastric MALToma

PURPOSE: To evaluate the radiologic findings of gastric MALToma, and to correlate these with its pathologic findings. MATERIALS AND METHODS: We retrospectively reviewed the pathologic slides of gastrectomy and gastroscopic biopsy specimens obtained between 1982 and 1996 and collected nine cases of gastric MALToma. Eight of these had been surgically confirmed, and one had been diagnosed by gastroscopic biopsy. A gastrointestinal series comprised eight cases ; five involved sonography and five, CT. RESULTS: The lesions were located at the body in five cases, at the antrum in one, and at the body and antrum in three cases. Pathologic diagnosis was low grade MALToma in four cases, and mixed high and low grade MALToma in five cases. Initial radiologic diagnosis was gastric lymphoma in four cases, early gastric carcinoma in three, and advanced gastric carcinoma in two cases. On retrospective analysis, radiologic diagnosis was changed to lymphoma in both cases initially diagnosed as advanced gastric carcinomas. One case showed marked thickening of the gastric wall, with poor enhancement on CT, and the other case showed a very small and shallow ulcer in comparison to diffuse infiltration of tumor in the upper gastrointestinal series. The final radiologic diagnosis was gastric lymphoma in six cases, and early gastric carcinoma in three. Radiologic findings of gastric MALToma were EGC II c-like lesion in three cases, marked gastric wall thickening in two, multiple discrete lesions in two, hyperugosity of gastric folds with discrete lesions in one, and diffuse infiltrative lesion with small ulcer in one case. The pathologic diagnosis of gastric MALToma was made by the presence of lymphoepithelial lesions, centrocyte-like cells, reactive follicles, plasma cell infiltration, and follicular colonization. There were no significant correlations between radiologic findings and pathologic results such as depth of tumor invasion, low grade MALToma or mixed high and low grade MALToma. CONCLUSION: There are no specific radiologic characteristics of gastric MALToma, but a gastric MALToma might show the radiologic findings of gastric lymphoma. Further radiologic evaluations of many cases of gastric MALTomas are needed in the future.

Gastritis Caused by lngestion of Eggs of Puffer Fish: A Case Report

Tetrodotoxin is a neurotoxin, so gastrointestinal symptoms are very rare ; these described in the literature are merely nausea and vomiting. Severe complications in the gastrointestinal tract caused by tetrodotoxin have not been radiologically reported. US and CT show thickening of the gastric wall and contraction of the lumen, andupper gastrointestinal series show shortening, lobulation and irregularity of the lesser and greater curevature ofthe body and antrum similar to the findings of corrosive gastritis.