Gastritis and Duodenitis

Inflammation of gastric mucosa induced by group of disorders that differ clinically but share similar imaging features

• Common etiologies include Helicobacter  pylori , NSAIDs, steroids, alcohol and coffee, stress

Erosive gastritis, complete or varioliform erosions (most common type)

• Erosions surrounded by radiolucent halos of edematous, elevated mucosa

• Scalloped or nodular antral folds

• Crenulation or irregularity of lesser curvature

• Location: Gastric antrum on crests of rugal folds

• Prolapse of antral mucosa through pylorus

• Lack of complete distensibility of stomach (especially antrum)

CT: Decreased wall attenuation (edema or inflammation)

• Close to water density

Upper GI series best for mucosal detail

• CT for global view and concern for extragastric complications (e.g., perforation)

Gastric carcinoma

Zollinger-Ellison syndrome

Acute pancreatitis

Gastric metastases and lymphoma

CT and upper GI usually just suggest gastritis

Specific etiology determined by other medical data ± endoscopic biopsy

Inflammation of gastric &/or duodenal mucosa induced by group of disorders that differs in etiological, clinical, histological, and radiological findings

Classification of gastritis

• Erosive or hemorrhagic gastritis (2 types)

  • –

    Complete or varioliform

  • –

    Incomplete or "flat"

• Antral gastritis

• Helicobacter pylori gastritis

• Hypertrophic gastritis (Ménétrier disease)

• Atrophic gastritis (2 types: A and B)

• Granulomatous gastritis (Crohn's disease and tuberculosis)

• Eosinophilic gastritis

• Emphysematous gastritis

• Caustic ingestion gastritis

• Radiation gastritis

• AIDS-related gastritis: Viral, fungal, protozoal, and parasitic infections

Best diagnostic clue

• Superficial ulcers and thickened folds