Learning objectives
1- Normal anatomy of the stomach on double-contrast barium study
2- Principles of Image analysis
3- Pattern approach for diagnosis
Background
The upper gastrointestinal series is a valuable diagnostic test for evaluating structural and functional abnormalities of the stomach. This article will introduce the normal radiographic anatomy of the stomach and the series imaging features of gastric lesions. A pattern approach for the diagnosis of gastric abnormalities will also be presented, focusing on protruded lesions,depressed lesions and gastric narrowing.
Findings and procedure details
Anatomy
There are five segments in the stomach: the cardia, fundus, body, antrum, and pylorus.
Cardia: Surrounds esophageal orifice into stomach. It is characterized on barium studies by three or four stellate folds that radiate to a central point at the gastroesophageal junction, also known as the cardiac “rosette”1.
Fundus: Most cephalic part of stomach, located superiorly and to left relative to cardia, touching left hemidiaphragm.
Body: Defined as the portion of the stomach extending from the gastric cardia to the smooth bend in the...
Conclusion
Although the volume of barium studies have been a slow decline in the past 35 years because of the increasing availability of endoscopy and advanced cross-sectional imaging modalities such as computed tomography(CT) and magnetic resonance(MR), barium studies have a clear advantage over endoscopy for evaluating submucosal and extrinsic mass lesions, assessing GI function and detecting postoperative complications. By learning the common lesions presented at double-contrast upper GI examination, we have the chance to clarify uncertain findings at endoscopy, CT or MR.
Personal information and conflict of interest
S. Y. Yu; Taipei/TW - Author at Taipei Veterans General Hospital
N.-C. Chiu; Taipei/TW - Nothing to disclose
References
Rubesin SE, Levine MS, Laufer I. Double-contrast upper gastrointestinal radiography: a pattern approach for diseases of the stomach. Radiology. 2008; 246(1):33-48.
Laufer I, Kressel HY. Principles of doublecontrast diagnosis. In: Levine MS, Rubesin SE, Laufer I, eds. Double contrast gastrointestinal radiology. 3rd ed. Philadelphia, Pa: Saunders, 2000; 8–46.
Islam RS et al: Gastric polyps: a review of clinical, endoscopic, and histopathologic features and management decisions. Gastroenterol Hepatol (N Y). 2013; 9(10):640-51.
Carucci LR, Levine MS, Rubesin SE, Laufer I. Tumorous gastric varices: radiographicfindings in 10...