Image Based Questions On Stomach, Duodenum And Peritoneim

Diagnosis: Gastric Antral Vascular Ectasia / Watermelon stomach 

Can see Parallel stripes of dilated blood vessels near antrum of stomach k/a Watermelon stomach · Pathology is Vascular ectasia · M/C site is Antrum of stomach · Diagnosed by Endoscopy with biopsy.

Diagnosis: Menetrier's Disease 

Gastrectomy specimen and endoscopic image showing massive gastric folds having cobble stone or cerebriform appearance suggesting menetrier's disease · Premalignant condition leading to increased risk of carcinoma stomach.

Diagnosis: Linis Plastica Aka Leather Bole Stomach 

Massively thickened wall of stomach suggesting Linis plastica · In Linis plastica there is massive proliferation of fibrous tissue in sub mucosa · It looks like leather bole on barium meal so k/a Leather bole stomach.

Diagnosis: Teapot Stomach or Handbag Stomach 

Due to gastric ulcer at lesser curvature and healing of this gastric ulcer causes longitudinal shortening of lesser curvature which gives the appearance of Tea pot.

Diagnosis: Hourglass Stomach 

Caused by Cicatricial contraction at lesser curvature due to saddle shaped ulcer give hour glass appearance on barium meal.

Diagnosis: Infantile Hypertrophic Pyloric Stenosis 

IOC is USG · Diagnosis can be made on barium meal but in USG there is no radiation exposure so USG is preferred over barium meal · On X-ray single bubble appearance seen · Double bubble appearance on X-ray: Duodenal atresia and Annular pancreas.

Important Signs of Hypertrophic Pyloric Stenosis

String sign - Most specific sign because of Narrowed pyloric canal · Double track sign - Due to redundant mucosa · Mushroom sign · Diamond sign - Aka Twining recess or Transient triangular tent sign · Olive pit sign · Teat sign · Shoulder sign - Due to the hypertrophied muscle indenting the antrum · Antral beaking sign.

Diagnosis: Pneumoperitoneum

Because of perforation peritonitis · On X-ray you can notice gas under right dome of diaphragm · Best investigation / IOC → CT · Most sensitive X-ray : Chest X-ray P.A view in erect posture · If patient who cannot stand the most sensitive x-ray is Le lateral decubitus view – Air layering up against liver seen.

Diagnosis: Retroperitoneal Fibrosis 

Due to Retroperitoneal fibrosis there is medial deviation of ureter and this appearance is k/a Pipe Stem ureter · On IVP there is medial deviation of ureter · Pipe stem ureter is also seen in TB.

Diagnosis: Mesenteric Cyst 

M/C type: Chylolymphac > Enterogenous · IOC for diagnosis: CECT · In CT you can see huge cyst in relation to bowel and mesentery.

Also read: High-Yield GIT, Hepatobiliary and Pancreatic Surgery Questions

Hope you found this blog helpful for your GIT, Hepatobiliary and Pancreatic Surgery preparation. For more informative and interesting posts like these, keep reading PrepLadder’s blogs.