google ads
Stomach: Gastric Emergencies Imaging Pearls - Educational Tools | CT Scanning | CT Imaging | CT Scan Protocols - CTisus
Imaging Pearls ❯ Stomach ❯ Gastric Emergencies

-- OR --

  • Dieulafoy's lesion (or Dieulofoy lesion) is a medical condition characterized by a large tortuous arteriole most commonly in the stomach wall (submucosal) that erodes and bleeds. It can present in any part of the gastrointestinal tract.[2] It can cause gastric hemorrhage[3] but is relatively uncommon. It is thought to cause less than 5% of all gastrointestinal bleeds in adults. It was named after French surgeon Paul Georges Dieulafoy, who described this condition in his paper "Exulceratio simplex: Leçons 1-3" in 1898.
  • “A Dieulafoy lesion describes a tortuous, submucosal artery in the gastrointestinal tract—most commonly the posterior stomach—that penetrates through the mucosa over time, eventually perforating to cause severe gastrointestinal bleeding. Due to its insidious onset, tendency to cause intermittent but severe bleeding, and difficulty of endoscopic diagnosis, Dieulofoy lesion has a very high mortality rate. Although originally thought not to be a radiologically diagnosable entity, Dieulofoy lesions can be seen at enhanced CT of the abdomen.”
    Dieulofoy lesion: CT diagnosis of this lesser-known cause of gastrointestinal bleeding
    A. Batouli et al.
    Clinical Radiology,Volume 70, Issue 6,2015,Pages 661-666
  • “A Dieulafoy lesion describes a tortuous, submucosal artery in the gastrointestinal tract—most commonly the posterior stomach—that penetrates through the mucosa over time, eventually perforating to cause severe gastrointestinal bleeding. The lesion is not associated with surrounding ulcer or inflammation. Due to its insidious onset, tendency to cause intermittent but severe bleeding, and difficulty of diagnosis, a Dieulofoy lesion has up to an 80% mortality rate. Due to intermittent and heavy bleeding, initial endoscopic evaluation often does not provide accurate diagnosis of Dieulofoy lesions.”
    Dieulofoy lesion: CT diagnosis of this lesser-known cause of gastrointestinal bleeding
    A. Batouli et al.
    Clinical Radiology,Volume 70, Issue 6,2015,Pages 661-666
  • "Dieulafoy lesions are twice as common in men as they are in women and can occur at any age, most commonly presenting in the fifth decade. Patients usually present with massive bleeding, most often without an associated prodrome of gastric complaints, which can be seen with ulcer disease. Interestingly, a large portion of presentations occur in patients that are already hospitalized for a different condition, pointing towards physiological stress as an inciting factor for arterial perforation.”
    Dieulafoy lesion: CT diagnosis of this lesser-known cause of gastrointestinal bleeding
    A. Batouli et al.
    Clinical Radiology,Volume 70, Issue 6,2015,Pages 661-666
  • "The CT findings of a Dieulafoy lesion include an abnormally enlarged submucosal vessel, which may appear serpentine, linear, or as a non-specific blush of apparent mucosal/submucosal contrast medium. Contrast medium within the bowel or stomach lumen makes the lesion more conspicuous and suggests active extravasation. It is important to view the gastric mucosa and bowel in as many imaging planes as possible, preferably at least two, as sagittal or coronal imaging may make the abnormally large submucosal vessel more easily identifiable.”
    Dieulafoy lesion: CT diagnosis of this lesser-known cause of gastrointestinal bleeding
    A. Batouli et al.
    Clinical Radiology,Volume 70, Issue 6,2015,Pages 661-666
  • "Near-definitive diagnosis of a Dieulafoy lesion can be obtained with enhanced CT of the abdomen. Optimal studies are performed in the arterial phase of intravenous contrast enhancement without administration of oral contrast material. CTA shows an enlarged submucosal arteriole in the gastrointestinal submucosal layer with or without active contrast medium extravasation into the lumen. Familiarity with the lesion and its manifestations can help guide radiologists to make the correct diagnosis in cases where endoscopy or standard angiography have failed. CT diagnosis can then help guide endoscopic and endovascular localization and treatment, ultimately improving patient outcomes.”
    Dieulafoy lesion: CT diagnosis of this lesser-known cause of gastrointestinal bleeding
    A. Batouli et al.
    Clinical Radiology,Volume 70, Issue 6,2015,Pages 661-666
  • “Gastritis can be secondary to many etiologies including infection, systemic illness such as trauma or burns, and autoimmune disease. Peptic ulcer disease is most commonly caused by Helicobacter Pylori infection and chronic NSAID use . The most common sites for ulcer formation are the gastric antrum/pylorus and proximal duodenum. The resultant edema and fibrosis around the ulcer site can cause narrowing and eventual obstruction of the gastric outlet [9]. Prior to the widespread use of H2 blockers and proton pump inhibitors, peptic ulcer disease was the most common cause of gastric outlet obstruction, however in the era of H2 blockers, outlet obstruction now predicts malignancy. While endoscopy is the modality of choice for diagnosing gastritis, CT is often performed first particularly in the setting of acute abdominal pain.”
    Imaging of acute gastric emergencies: a case-based review  
    Jetty S et al.
    Clinical Imaging 72 (2021) 97–113
  • “On imaging, it can be difficult to distinguish benign peptic ulcer disease from malignant causes of gastric outlet obstruction and biopsy is required for confirmation. Peptic ulcers can perforate and should be recognized on imaging.”
    Imaging of acute gastric emergencies: a case-based review  
    Jetty S et al.
    Clinical Imaging 72 (2021) 97–113
  • “On CT, gastritis will appear as wall thickening with alternating hyper- and hypoattenuation representing mucosal enhancement and submucosal edema. The presence of mucosal enhancement (hyperemia) on CT suggests gastritis as the cause of gastric wall thickening. An uncommon form of gastritis is emphysematous gastritis. It is usually caused by gas-forming Escherichia coli. Initially obtained AXR may show mottled gas outlining the gastric wall. CT can confirm the diagnosis. Mottled gas can also be a sign of gastric pneumatosis from ischemia.”
    Imaging of acute gastric emergencies: a case-based review  
    Jetty S et al.
    Clinical Imaging 72 (2021) 97–113
  • "Primary gastric cancer (GC) is a common cause of cancer related death worldwide and can initially present as a gastric ulcer. The characteristic CT finding in GC is disruption of the multilayered pattern of the gastric wall enhancement with thickening, variable enhancement and ulceration. Malignancy is the most common cause of gastric outlet obstruction. Malignant obstruction is an advanced disease presentation that occurs in up to 20% of patients with primary pancreatic, gastric, or duodenal carcinomas. It can be intrinsic or extrinsic. Extrinsic obstruction is almost always due to compression of the gastric outlet from tumor growth in surrounding organs. It is most commonly seen with primary tumors of the pancreas and duodenum.”
    Imaging of acute gastric emergencies: a case-based review  
    Jetty S et al.
    Clinical Imaging 72 (2021) 97–113
  • "Fistulae can form between the stomach and adjacent viscera. In patients with chronic cholecystitis or long-standing cholelithiasis gradual erosion can develop between the inflamed gallbladder wall and stomach or first part of duodenum. The Gallstone can extend into the bowel and cause gallstone ileus, a relatively rare cause of a mechanical small bowel obstruction. CT with contrast is the imaging modality of choice. The gallstone becomes impacted in the ileocolic valve and results in pneumobillia, ectopic gallstone and proximal small bowel dilatation. A rarer form of gallstone ileus can occur where the stone is impacted in the pylorus or the duodenum and is called Bouveret syndrome. Morbidity is high and has been reported as high as 33%.”  
    Imaging of acute gastric emergencies: a case-based review  
    Jetty S et al.
    Clinical Imaging 72 (2021) 97–113
  • “The most frequent and sensitive CT findings of volvulus with high positive likelihood ratios were stenosis at the hernia neck (reader 1, sensitivity = 80%, positive likelihood ratio = 26.66; reader 2, sensitivity = 77%, pos- itive likelihood ratio = 12.83) and transition point at the pylorus (reader 1, sensitivity = 80%, positive likelihood ratio = 17; reader 2, sensitivity = 70%, positive likelihood ratio = 15). The presence of perigastric fluid or a pleural effusion were significantly more frequent in patients with ischemia at surgical pathology (p < 0.05 in all comparisons, both radiologists).”
    CT of Gastric Volvulus: Interobserver Reliability, Radiologists’ Accuracy, and Imaging Findings
    Mazaheri P et al.
    AJR 2019; 212:103–108
  • OBJECTIVE. The objective of this study was to identify CT findings and determine interobserver reliability of surgically proven gastric volvulus.
    CONCLUSION. In our series, CT showed substantial interobserver agreement and fair accuracy in identifying the presence of gastric volvulus.
    CT of Gastric Volvulus: Interobserver Reliability, Radiologists’ Accuracy, and Imaging Findings
    Mazaheri P et al.
    AJR 2019; 212:103–108
  • “Gastric volvulus refers to at least 180°rotation of the stomach and leads to gastric outlet obstruction, impairment of vascularity, eventually ischemia. It is a rare condition with unknown exact incidence or prevalence. Although 70% of patients present with the Borchardt triad, a combination of severe epigastric pain, retching, and inability to pass a nasogastric tube, the clinical presentation may not be classic.”
    CT of Gastric Volvulus: Interobserver Reliability, Radiologists’ Accuracy, and Imaging Findings
    Mazaheri P et al.
    AJR 2019; 212:103–108
  • “Because of its rarity and the overlap in appearance with large hiatal hernias, gastric volvulus remains a challenging condition to diagnose with CT. Acute gastric volvulus may lead to gangrene in 5–28% of patients, so missing or delaying an appropriate diagnosis can have grave consequences.”
    CT of Gastric Volvulus: Interobserver Reliability, Radiologists’ Accuracy, and Imaging Findings
    Mazaheri P et al.
    AJR 2019; 212:103–108
  • “Acute gastric volvulus is a surgical emergency with high morbidity and mortality. The diagnosis of gastric volvulus is difficult to make clinically because symptoms are nonspecific, so imaging is performed to aid in diagnosis. For this reason, radiologists must be familiar with diagnostically useful CT findings of gastric volvulus to enable early detection and reduce morbidity and mortality in this patient population.”
    CT of Gastric Volvulus: Interobserver Reliability, Radiologists’ Accuracy, and Imaging Findings
    Mazaheri P et al.
    AJR 2019; 212:103–108
  • “CT findings of overt ischemia including gastric wall edema, poor gastric wall enhancement, perigastric fluid, pneumatosis, pleural effusion, and pneumoperitoneum were uncommonly seen in our study and, though insensitive, were highly specific for volvulus with near complete agreement. Among these findings of ischemia, perigastric fluid and pleural effusion had the highest sensitivities (30–47% and 27–37%, respectively) for gastric volvulus.”
    CT of Gastric Volvulus: Interobserver Reliability, Radiologists’ Accuracy, and Imaging Findings
    Mazaheri P et al.
    AJR 2019; 212:103–108
  • “Competitive eaters are known to be able to accommodate large quantities of food particles within their flaccid stomach sac conditioned by repeated rapid distension of the gastric wall during their gobbling episodes. These individuals are at risk of gastroparesis, aspiration pneumonia, gastric perforation, Mallory-Weiss tear, Boerhaave syndrome, and morbid obesity. Rapid and gross gastric distension owing to the consumption of food items that are not chewed results in large chunks of solid food particles accumulating in the stomach, preventing food from entering the duodenum.”
    The Perils of Competitive Speed Eating!
    Lim TZ1, Rajaguru K1, Lee CL1.
    Gastroenterology. 2018 Jun;154(8):2030-2032
  • “Despite the health consequences illustrated, many of these competitors seek the fame and glory associated with accomplishing such incredible feats and continue to test the limits of human health.”
    The Perils of Competitive Speed Eating!
    Lim TZ1, Rajaguru K1, Lee CL1.
    Gastroenterology. 2018 Jun;154(8):2030-2032
  • “Gastric pneumatosis , also referred to as gastric emphysema or emphysematous gastritis, is the least common site of pneumatosis within the gastrointestinal tract, seen in 9% of cases in a single review of 86 patients with gastrointestinal pneumatosis on CT. The term gastric pneumatosis encompasses both gastric emphysema and emphysematous gastritis, with the latter referring specifically to the uncommon, though life-threatening, infectious variant. Dependent tiny locules or linear collections of gas within the dependent gastric wall raise concern for pneumatosis, though gas within the rugae may mimic true pneumatosis. Correlation with sagittal and coronal reconstructions as well as persistence between arterial and portal venous phases may aid in diagnosis.”


    Nonmalignant gastric causes of acute abdominal pain on MDCT: a pictorial review.
Fung CI, Fishman EK
Abdom Radiol (NY). 2016 Aug 1. [Epub ahead of print]
  • “While gastritis may diffusely involve the stomach, focal, and segmental thickening can alternatively be seen, particularly in the setting of Helicobacter pylori infection or with medications such as nonsteroidal anti-inflammatory drugs (NSAIDs). NSAID-induced gastritis occurs secondary to decreased prostaglandin synthesis, resulting in decreased mucus and bicarbonate secretion with subsequent gastric injury. Focal gastritis or ulcers secondary to NSAIDs or other medications classically occur along the gastric body and antrum along the greater curvature  due to their dependent position. Focal wall thickening may mimic neoplasm; due to the overlap between MDCT appearance and gastric neoplasm, endoscopy is often required for definitive diagnosis.”


    Nonmalignant gastric causes of acute abdominal pain on MDCT: a pictorial review.
Fung CI, Fishman EK
Abdom Radiol (NY). 2016 Aug 1. [Epub ahead of print]
  • “A number of causes of gastric pneumatosis have been described including infection, ischemia, medications, endoscopic procedures, and idiopathic. MDCT may aid in determining the underlying cause and directing 
 52-year-old man, acute abdominal pain. Axial venous phase MDCT. Perforating ulcer (long arrow) arising from the stomach antrum (S) with gastric content filling the lesser sac and secondary pneumoperitoneum (short arrow). 
subsequent management. Early endoscopy with gastric biopsy can similarly help determine the underlying etiology, particularly in differentiating infectious and non- infectious causes. Elevated lactate has been associated with increased mortality on one multivariate analysis.”


    Nonmalignant gastric causes of acute abdominal pain on MDCT: a pictorial review.
Fung CI, Fishman EK
Abdom Radiol (NY). 2016 Aug 1. [Epub ahead of print]
  • “Gastric ulcers are common and often result from H. pylori infection or medications, especially NSAIDs. Superficial ulcers are not typically well visualized on MDCT; however, deep or penetrative ulcers may be appreciated. Secondary inflammation can result in adjacent wall thickening or other soft tissue change. Extraluminal gas or pneumoperitoneum may be present in cases of perforation.”


    Nonmalignant gastric causes of acute abdominal pain on MDCT: a pictorial review.
Fung CI, Fishman EK
Abdom Radiol (NY). 2016 Aug 1. [Epub ahead of print]
  • “Upper gastrointestinal bleeding accounts for approximately 0.1% of hospitalizations in the USA each year, with a mortality rate of 10%. Common causes of gastric hemorrhage  include ulcers, varices, Mallory– Weiss tears, vascular lesions, and neoplasms. Clinical presentation varies depending on the degree of blood loss, ranging from asymptomatic with less than 00 mL/day to systemic shock if greater than 15% of the circulating blood volume is lost. Contrast-enhanced MDCT may allow direct visualization of the bleeding site via high-attenuating contrast extravasation. In the absence of contrast, high-attenuating debris within the stomach fundus can suggest ongoing or prior hemorrhage, particularly in hospitalized patients without recent ingestion with unexplained anemia or abdominal pain.”

    
Nonmalignant gastric causes of acute abdominal pain on MDCT: a pictorial review.
Fung CI, Fishman EK
Abdom Radiol (NY). 2016 Aug 1. [Epub ahead of print]
  • “Although uncommon, foreign body ingestion  may result in dramatic imaging findings. Foreign body ingestions are most common in children, the intellectually disabled, and individuals with predisposing factors or injurious situational problems (e.g., suicidal ideation, anxiety, alcohol abuse, etc.). Clinical history is critical and MDCT is often performed to exclude complications. The vast majority of objects pass through the gastrointestinal tract without issue. Elongate or sharp objects have increased risk of perforation or obstruction. Secondary complications including mediastinitis, peritonitis, abscess formation, or sepsis may occur following perforation. High-risk objects including sharp or large foreign bodies may require endoscopic or surgical removal.”

    
Nonmalignant gastric causes of acute abdominal pain on MDCT: a pictorial review.
Fung CI, Fishman EK
Abdom Radiol (NY). 2016 Aug 1. [Epub ahead of print]
  • “Unlike the majority of gastrointestinal fistulae, which are often iatrogenic or related to inflammatory bowel disease, gastrocolic fistulae are most commonly caused by penetrating benign ulcers in the setting of NSAID use. Neoplasm and inflammation are less common causes. Classically patients present with acute halitosis, feculent vomiting, and undigested food, though the most common clinical presentation is nonspecific abdominal pain.”


    Nonmalignant gastric causes of acute abdominal pain on MDCT: a pictorial review.
Fung CI, Fishman EK
Abdom Radiol (NY). 2016 Aug 1. [Epub ahead of print]
  • “Most commonly seen in elderly women with a history of biliary disease, gallstone-associated gastric outlet obstruction—or ‘‘Bouveret’s Syndrome’’—is a rare condition caused by retrograde passage of a large gallstone into the duodenum or stomach with subsequent obstruction. Although the least common location for gallstones to become lodged, early recognition or duodenal or gastric gallstone obstruction is critical due to a reported mortality of 30%. MDCT or radiographs may aid in the diagnosis prior to invasive assessment through visualization of the gallstone or secondary features including pneumobilia and gastric distension; however, endoscopy is diagnostic. As with the related condition of gallstone ileus, management is surgical.”


    Nonmalignant gastric causes of acute abdominal pain on MDCT: a pictorial review.
Fung CI, Fishman EK
Abdom Radiol (NY). 2016 Aug 1. [Epub ahead of print]
  • “The term gastric volvulus implies at least 180° rotation of the stomach and gastric outlet obstruction. Coronal reformatted images are particularly helpful in diagnosing gastric volvulus and often show these findings to greater advantage than axial images alone. Organoaxial or mesenteroaxial rotation of the stomach alone does not define volvulus.”


    CT of Gastric Emergencies.
Guniganti P et al.
Radiographics. 2015 Nov-Dec;35(7):1909-2
  • “Therefore, the degree
of distention determines the thickness of the normal gastric wall and folds. In an adequately distended stomach, the normal nondependent gastric body is less than or equal to 5 mm in thickness. The antral wall, in contrast, may normally measure less than or equal to 12 mm in thickness.”

    CT of Gastric Emergencies.
Guniganti P et al.
Radiographics. 2015 Nov-Dec;35(7):1909-2
  • “Inadequate gastric distention limits diagnostic evaluation of the stomach and poses a potential pitfall, as it may create a false appearance of thickening or, conversely, may obscure true disease. When evaluating abnormal gastric wall thickening in a nondistended stomach, supplementary findings can be helpful in identifying disease. Findings that should raise suspicion for gastric disease include focal or ec- centric gastric wall thickening, low attenuation or nodularity of the gastric wall, mucosal hyper- enhancement, and adjacent fat stranding.”


    CT of Gastric Emergencies.
Guniganti P et al.
Radiographics. 2015 Nov-Dec;35(7):1909-2
  • “Gastritis, or gastric mucosal inflamma- tion, is a common condition that often results in submucosal edema and hyperplasia of the gastric mucosa . Gastritis is most frequently secondary to Helicobacter pylori infection, nonsteroidal anti-inflammatory drugs (NSAIDs), alcohol, or systemic illness. Patients with gastritis may present with epigastric pain, nausea, vomiting, or loss of appetite. ”

    CT of Gastric Emergencies.
Guniganti P et al.
Radiographics. 2015 Nov-Dec;35(7):1909-2
  • “The combination of mucosal hyperemia with submucosal edema results in the appearance described as mural stratification, which is most pronounced at arterial phase imaging. Gastritis may be focal, segmental, or diffuse. Gastritis due to H pylori infection can have a variety of manifestations, including circumferential antral wall thickening and focal thickening along the greater curvature.”


    CT of Gastric Emergencies.
Guniganti P et al.
Radiographics. 2015 Nov-Dec;35(7):1909-2
  • “Emphysematous gastritis is an uncommon condition with a high mortality rate and is caused by mucosal disruption and invasion of microorganisms into the gastric wall, producing intramural gas. Causative microorganisms reported in the literature include both aerobic and anaerobic bacteria as well as fungal species. Frequently isolated organisms include Escherichia coli, Klebsiella pneumoniae, Enterobacter species, Pseudomonas aeruginosa, and Candida species”

    CT of Gastric Emergencies.
Guniganti P et al.
Radiographics. 2015 Nov-Dec;35(7):1909-2
  • “Air in the gastric wall can be seen in a benign form of gastric emphysema, which can be encountered in the setting of a recent procedure and is typically asymptomatic. Patients with benign gastric emphysema demonstrate few clinical symptoms, whereas emphysematous gastritis causes patients 
to present with severe pain and potentially with sepsis and shock. ”


    CT of Gastric Emergencies.
Guniganti P et al.
Radiographics. 2015 Nov-Dec;35(7):1909-2
  • “Volvulus occurs most often in elderly patients with a hiatal hernia and may be acute or chronic-recurrent. Paraesophageal hernias, particularly large type III hernias, are at greater risk of gastric volvulu. Because of the potential for ischemia and perforation, acute gastric volvulus has high morbidity and mortality if not treated rapidly with decompression of the stomach, reduction of the volvulus, and correction of the underlying cause. ”


    CT of Gastric Emergencies.
Guniganti P et al.
Radiographics. 2015 Nov-Dec;35(7):1909-2
  • “Gastric volvulus is divided into two subtypes, organoaxial and mesenteroaxial, based on the axis of rotation. Organoaxial volvulus is obstruction of the stomach due to rotation around the long axis of the stomach, resulting in the antrum moving anterosuperiorly and the fundus rotating posteroinferiorly, so that the greater curvature lies superior to the lesser curvature. In mesenteroaxial volvulus, the stomach rotates around its short axis, such that the antrum moves above the gastroesophageal junction, twisting its vascular supply. ”


    CT of Gastric Emergencies.
Guniganti P et al.
Radiographics. 2015 Nov-Dec;35(7):1909-2
  • “Organoaxial volvulus 
is more common than mesenteroaxial volvulus, accounting for approximately two-thirds of cases, and is commonly associated with congenital and 
acquired diaphragmatic defects. Many cases may have overlapping features of organoaxial and mes- enteroaxial volvulus and indeed may be due to a combination of these two entities. ”

    CT of Gastric Emergencies.
Guniganti P et al.
Radiographics. 2015 Nov-Dec;35(7):1909-2
  • “Perforation is the most common complication of PUD. Ulcers on the anterior wall and curvatures perforate freelyinto the peritoneal space; posterior ulcers may perforate into the lesser sac and can be relatively contained. Findings at CT may include the features of gastric ulcers discussed previously in combination with free intraperitoneal fluid or gas, extraluminal oral contrast material, and wall discontinuity. Ulcers are more likely to be detected at CT when they perforate, because the defect is transmural and because extraluminal gas and fluid may accumulate at the site of perforation. ”

    CT of Gastric Emergencies.
Guniganti P et al.
Radiographics. 2015 Nov-Dec;35(7):1909-2
  • “Gastric perforation can also occur with a gastric malignancy, particularly in ulcerated masses such as those seen with adenocarcinoma, lymphoma, and large gastrointestinal stromal tumors (GISTs). Perforation from gastric adenocarcinoma typically occurs in patients more than 65 years of age with advanced stage disease. In patients with lower stage disease, a focal ulcerated mass can perforate if the ulceration is deep. ”


    CT of Gastric Emergencies.
Guniganti P et al.
Radiographics. 2015 Nov-Dec;35(7):1909-2
  • “Gastric hemorrhage can be seen in a variety of gastric diseases, including PUD, tumor, varices, gastritis, and arteriovenous malformations. Patient presentation is variable, ranging from asymptomatic to hypovolemic shock. Direct signs of bleeding include hematemesis, coffee-ground emesis, melena, or, in the setting of rapid bleeding, hematochezia. Although endoscopy is the preferred method of diagnosing and treating upper gastrointestinal bleeding, CT is useful in cases where endoscopy is not clinically feasible or is nondiagnostic.”


    CT of Gastric Emergencies.
Guniganti P et al.
Radiographics. 2015 Nov-Dec;35(7):1909-2
  • “CT findings of gastric hemorrhage include intraluminal contrast blush from active bleeding or hyperattenuating clot from recent bleeding. Clots in these cases are often seen in the fundus, which is the most dependent location in the supine patient. The location of the highest- attenuation clot (the sentinel clot) can indicate the source of bleeding.”

    CT of Gastric Emergencies.
Guniganti P et al.
Radiographics. 2015 Nov-Dec;35(7):1909-2
  • “Hyperattenuating material in the stomach, including ingested material such as residual contrast medium or medications, surgical material, or foreign bodies, can potentially result in both false-positive and false-negative studies by mimicking or obscuring bleeding. Obtaining a non- contrast scan can avoid this imaging pitfall. Even in the absence of active bleeding, CT may be helpful in identifying the underlying culprit.”


    CT of Gastric Emergencies.
Guniganti P et al.
Radiographics. 2015 Nov-Dec;35(7):1909-2
  • “Gastric ischemia is an uncommon condition caused by diffuse or focal vascular insufficiency. Although the extensive collateral blood supply to the stomach is protective, systemic hypoten- 
sion (as is seen in sepsis or shock) may result
in gastric ischemia. Other described causes of gastric ischemia include celiac and mesenteric stenosis, vasculitis, and disseminated thrombo- embolism.”


    CT of Gastric Emergencies.
Guniganti P et al.
Radiographics. 2015 Nov-Dec;35(7):1909-2
  • “Imaging findings in gastric ischemia range from focal ulceration to gastric wall thickening to intramural gas. Ischemic ulcerations most commonly occur along
the anterior and posterior gastric walls near the anastomoses between the two arterial arches over the lesser and greater curvatures. Gastric dilatation may also be seen and is thought to be due to ischemic gastroparesis .”

    CT of Gastric Emergencies.
Guniganti P et al.
Radiographics. 2015 Nov-Dec;35(7):1909-2

Privacy Policy

Copyright © 2024 The Johns Hopkins University, The Johns Hopkins Hospital, and The Johns Hopkins Health System Corporation. All rights reserved.