Where are Gastric diverticula located within the stomach?
Fundus (congenital and less curve) or
antrum (acquired and greater curve)
When does pyloric stenosis occur?
What are the imaging criteria for diagnosis?
Infantile pyloric stenosis: First 6 weeks of life with projectile bilious vomiting.
Pylorus length of 15mm and diameter of 3mm
What are the types of volvulus?
Which is more common?
Organoaxial- long axis rotation (most common)
Mesenteroaxial- Rotation along mesenteric axis
Which type of hiatal hernia is associated with gastric volvulus?
Oganoaxial gastric volvulus is associated with sliding hiatal hernia
What are benign causes of diffuse gastric thickening?
Malignant?
Benign
- Pseudolymphoma
- Gastritis
- Varicies
Malignant
- Lymphoma
- Carcinoma (Linitis Plastica)
- mets
Factors which suggest a gastric ulcer is malignant?
- Non-antral location
- Eccentric position on mucosal mound
- Irregular margin
- Absence of or irregular Hampton’s line (i.e. ulcer collar)
- mucosal folds do not reach ulcer margin
What are complications of benign gastric ulcers?
- perforation
- erosion into vessel
- antral scaring (and gastric outlet obstruction)
What type of gastric ulcers is Crohn’s disease associated with?
What is their morphology
- Aphthous ulcers
- small bull’s eye appearance on UGI
What is the most commonly affected GI organ in sarcoidosis?
The stomach
Types of infectious gastritis? Populations each affects?
- phlegmanous: alcoholics
- emphysematous: diabetics
- tb: endemic areas
- syphilis
- candidal: immunocompromised
What is menetrier disease?
AKA hypertrophic gastritis. Gastritis with gastric fold hypertrophy, hypoalbuminemia, and weight loss.
Most common causes of gastritis?
- Helicobactor pylori
- NSAIDS, KCl, clopidogrel, steroids
- EtOH
- Crohn Diseas
- CMV, HSV
- Behchet syndrome
Imaging findings associated with Zollinger Ellison Syndrome?
- Massive ulceration of the gastric antrum and proximal small bowel including the jejunum
- Hypervascular arterially enhancing small tumor in the duodenum (most common) or pancreas
What is the pathophysiology of atrophic gastritis?
Gastrinoma > parietal cell hyperplasia and acid hypersecretion > ulcers
What is the etiology of atrophic gastritis?
- Prolonged H. Pylori
- Autoimmune gastritis
What syndromes are associated with adenomatous gastric polyps?
Adenomatous polyps are associated with carcinoma
Gardner
Familial polyposis coli
What syndromes are associated with hamartomatous gastric polyps?
- Peutz Jeghers
- Crobkhite Canada
What organs are affected in Cowden syndrome?
- GI
- breast cancer
- thyroid follicular cancer
- CNS dysplasia - lhermitte duclose
Where do gastrointestinal stromal tumors most commonly arise?
What is their histologic location?
#1 stomach #2 small intestine #3 esophagus
Submucosal. Arise from cells of cajal which express c kit
Carney Triad?
- GIST
- Extra adrenal paraganglioma
- pulmonary chondroma
Imaging appearence of GIST?
- Smooth submucosal mass with possible central ulcer if large
- heterogeneous enhancement with areas of necrosis is larger.
- 25% demonstrate calcification
Symptoms of ectopic pancreas?
Location of ectopic pancreas?
Bleeding
Submucosal of gastric antrum or proximal duodenum
Imaging characteristics of ectopic pancreas
- submucosal mass in antrum or duodenum with central umbilication that represents rudimentary pancreatic duct
What disease is are Gastric varicies associated with?
Esophageal varicies?
- Splenic vein thrombosis (secondary to pancreatitis or pancreatitis). Although may also be seen in portal htn
- portal htn
