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GI Bleed

GI Bleed

 

GI Bleed

 

GI Bleed

 

RCC Metastatic to Stomach with Ulceration and Bleed

RCC Metastatic to Stomach with Ulceration and Bleed

 

Benign Gastric Tumors

  • 85-90% of gastric tumors
  • Numerous different tumor types
    • Neurogenic tumors (neurinomas, schwannomas)
    • Smooth Muscle Tumors
    • Lipomas
    • Gastric polyps (hyperplastic in up to 90% of cases)

 

Gastric Polypoid Mass: Inflammatory Polyp

Gastric Polypoid Mass: Inflammatory Polyp

 

Gastric Polypoid Mass: Inflammatory Polyp

 

Gastric Lipomas: Facts

  • Less than 1% of gastric tumors and less than 5% of GI tract lipomas
  • Submucosal in location
  • Usually found in the gastric antrum
  • Usually incidental finding but if >3-4 cm can present with ulceration and hemorrhage or intussuception

 

Gastric Lipomas: CT Appearance

  • Well circumscribed
  • Fat attenuation (-70 to -120 HU)
  • May have ulceration centrally although unusual in tumors under 6 cm
  • Always benign

 

Gastric Lipoma

Gastric Lipoma

 

Gastric Lipoma

 

Gastric and Small Bowel Lipomas

Gastric and Small Bowel Lipomas

 

Gastric and Small Bowel Lipomas

Gastric and Small Bowel Lipomas

 

Gastric and Small Bowel Lipomas

 

? Gastric Duplication Cyst

? Gastric Duplication Cyst

 

Gastric Duplication Cyst

Gastric Duplication Cyst

 

Gastric Duplication Cyst

 

Gastric Duplication Cyst

 

Gastric Duplication Cyst with Cinematic Rendering

Gastric Duplication Cyst with Cinematic Rendering

 

Gastric Duplication Cyst

Gastric Duplication Cyst

 

Gastric Duplications: Facts

  • 7% of gastrointestinal tract duplications.
  • Most are noncommunicating, spheric or ovoid closed cysts, and the most common site is the greater curvature
  • The mucosal lining is usually gastric, but pseudostratified respiratory epithelium and pancreatic tissue have been found
  • The clinical picture depends on their size and location as well as the presence of communication with the rest of the alimentary tract.

 

Abdominal Pain

Abdominal Pain

 

Abdominal Pain

 

Abdominal Pain

 

Abdominal Pain

Abdominal Pain

 

Abdominal Pain

 

Abdominal Pain

 

Heterotopic Pancreas Tissue

Heterotopic Pancreas Tissue

 

Heterotopic Pancreas Simulates Cystic Tumor

Heterotopic Pancreas Simulates Cystic Tumor

 

“Heterotopic pancreas is an entity in which pancreatic elements are found outside of the gland proper. In the literature, it is defined as elements without anatomic or vascular connection to the gland. It is overall a relatively uncommon entity with a reported incidence of 0.5%–14% in autopsy series . The true incidence is unknown as most cases are asymptomatic.”
Heterotopic pancreatic rests: imaging features, complications, and unifying concepts
Kim DU, Lubner MG, MellnicknV.M. et al.
Abdom Radiol (2016). doi:10.1007/s00261-016-0874-9

 

“The stomach and duodenum have been variably described as the most common sites of involvement with reported frequencies of 24%–38% and 9%–36%, respectively. Gastric lesions are typically located in the antrum, along the greater curvature, within 3–6 cm of the pylorus, while duodenal lesions are located in the proximal portions. Both gastric and duodenal lesions are typically round or ovoid and located in the submucosa with an endophytic growth pattern. Occasionally, heterotopic pancreatic elements have been found in the muscularis propria or serosa.”
Heterotopic pancreatic rests: imaging features, complications, and unifying concepts
Kim DU, Lubner MG, MellnicknV.M. et al.
Abdom Radiol (2016). doi:10.1007/s00261-016-0874-9

 

“Most cases of pancreatic heterotopia are asymptomatic and incidentally discovered. The symptomatic cases are most commonly encountered in 40–50 year old males. The most common symptom is upper abdominal pain with less common symptoms, including nausea, vomiting, weight loss, and jaundice . Symptoms are postulated to be secondary to complications of pancreatic heterotopia, which can be broadly divided into two categories—those possible in any mass, largely determined by location, and those specific to pancreatic tissue.”
Heterotopic pancreatic rests: imaging features, complications, and unifying concepts
Kim DU, Lubner MG, MellnicknV.M. et al.
Abdom Radiol (2016). doi:10.1007/s00261-016-0874-9

 

Chemical Gastritis

  • Often due to NSAID, corticosteroid, or antibiotic use
  • MDCT findings:
    • Focal antral wall thickening
    • Adjacent fat stranding
    • May directly visualize ulcer(s)
    • Assess for fistula formation
  • Clinical concern may prompt endoscopy, particularly with features concerning for neoplasm:
    • Focal wall thickening >1cm
    • Enhancing eccentric wall thickening
  • Clinical management:
    • Endoscopy if concern re: neoplasm
    • Cessation of causative agent
Chemical Gastritis

 

Chemical Gastritis from NSAIDs

Chemical Gastritis from NSAIDs

 

Chemical Gastritis from NSAIDs

 

Chemical Gastritis from NSAIDs

 

Chemical Gastritis from NSAIDs

 

 
 

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