Usefulness of conventional ultrasonography in identifying normal and abnormal gastric antrum.

AIM

This study evaluates the usefulness of measuring gastric antral thickness on conventional ultrasonography as a means of suggesting gastric antral pathology. Normal and abnormal appearances of the gastric antrum are reviewed.

METHOD

The control group consisted of 156 patients with a mean age of 43 years (SD 11 years). The control group represented a population with no history or physical findings to suggest possible gastric pathology. The true positives represented six patients with proven gastric antral carcinoma on presentation.

RESULTS

The mean value of the greatest thickness of one wall of the gastric antrum in the control group was 5.5 mm (SD 1.9 mm). The 95% confidence interval was 5.2-5.8 mm. The normal range was 1.3-10 mm. This was compared with 6 patients with proven gastric antral carcinoma who presented at the same time-frame of 4 months in which the control study was performed. The mean value of the thickness of the gastric antrum in these patients was 17.7 mm (SD 1.9 mm). The p-value on two-tailed t-test comparison between the two groups was 0.0009 which is statistically significant. This finding is in keeping with the fact that at presentation most gastric antral carcinomas are advanced.

CONCLUSION

This study recommends that patients with epigastric pain (gallbladder vs peptic ulcer disease), hypochromic microcytic anaemia, marked weight loss and unknown primary malignancy would benefit from ultrasonography of the gastric antrum at the time of abdominal scan. If the measurement of one wall of the gastric antrum is more than 10 mm and particularly if this is associated with an abnormal echo, the patient should be endoscoped fairly urgently.