Learning objectives
Review and illustrate the CT findings of urgent gastric pathology.
Describe the key points for diagnostic imaging of gastric emergencies.
Background
Abdominal pain,
nausea and vomiting are very frequent symptoms in patients who go to the emergency service.
These symptoms can be secondary to pathologies such as gastritis,
carcinoma,
lymphoma,
carcinoid,
metastasis,
bezoar or corrosive damage of the stomach.
Clinical and laboratory tests are frequently nonspecific,
so when faced with the suspicion of urgent gastric pathology,
CT will be the initial test of choice for diagnosis and treatment planning.
Endoscopy remains an important tool for assessing acute gastric disease,
although it is more invasive and not...
Findings and procedure details
The stomach is divided into five segments: the cardia,
the fundus,
the body,
the antrum and the pylorus.
The arterial supply to the stomach comes from the three branches of the celiac axis: the left gastric,
common hepatic and splenic arteries,
forming two arterial arches.
Numerous anastomoses make the stomach relatively resistant to ischemia.
The gastric wall is composed of mucosa,
submucosa,
muscularis propria and serosa.
It presents a trilaminar appearance after the administration of contrast (can increase up to 120 HU) that is altered...
Conclusion
With the development of new and better software techniques,
the use of CT is becoming more frequent in urgent abdominal pathology.
Although endoscopy plays an important role in the evaluation of acute gastric pathology,
CT is often the first imaging technique performed in the emergency department and offers a quick and accurate diagnosis that helps plan treatment.
It is important to be familiar with the characteristics of CT in various gastric disorders for proper diagnosis and treatment.
References
Horton KM,
Fishman EK.
Current role of CT in imaging of the stomach.
Radiographics.
2003 Jan-Feb;23(1):75-87.
Nagpal P,
Prakash A,
Pradhan G,
Vidholia A,
Nagpal N,
Saboo SS,
Kuehn DM,
Khandelwal A.
MDCT imaging of the stomach: advances and applications.
Br J Radiol.
2017 Jan;90(1069):20160412.
Sunnapwar A,
Ojili V,
Katre R,
Shah H,
Nagar A.
Multimodality imaging of adult gastric emergencies: A pictorial review.
Indian J Radiol Imaging.
2017 Jan-Mar;27(1):13-22.
Dheer S,
Levine MS,
Redfern RO,
Metz DC,
Rubesin SE,
Laufer I.
Radiographically diagnosed antral...