Imaging studies such as water-soluble contrast enemas and computed tomography (CT) are often performed on the postoperative colon to exclude complications such as anastomotic leaks, strictures, fistulas, and abscesses. This chapter discusses the postoperative anatomy and major complications that occur…
Barium enemas are not commonly performed in modern radiology practice because of greater use of other diagnostic tests such as colonoscopy, computed tomography (CT), and, most recently, CT colonography. As senior radiologists retire, it has become increasingly difficult for young…
Gastric Varices Pathophysiology Portal Hypertension The gastric fundus is normally drained by numerous short gastric veins that anastomose distally with the splenic vein and proximally with the coronary vein and venous channels surrounding the distal esophagus. The short gastric veins…
Metastases Gastric and duodenal metastases are found at autopsy in less than 2% of patients who die of carcinoma. Most of them are blood-borne metastases, but the stomach and duodenum are also involved by lymphatic spread or by direct extension…
Gastric Carcinoma EPIDEMIOLOGY Gastric carcinoma has striking geographic variations, with the highest reported incidence in Japan. However, Japanese who migrate to the United States have a significantly lower incidence of gastric cancer than those living in Japan, so other factors…
Between 85% and 90% of neoplasms in the stomach and duodenum are benign. About 50% are mucosal lesions and 50% are submucosal. Most benign neoplasms are discovered fortuitously on barium studies or endoscopy, but large or ulcerated tumors may cause…
Erosive Gastritis Erosions are defined histologically as epithelial defects that do not penetrate beyond the muscularis mucosae. Although gastric erosions are rarely diagnosed on single-contrast upper gastrointestinal (GI) studies, they are detected on double-contrast studies in 1% to 20% of…
Gastric or duodenal ulcers (peptic ulcers) are thought to occur in about 10% of adults in the West. Peptic ulcers are important not only because of the frequent occurrence of pain or other symptoms but also because of the morbidity…
Radiographic Technique The gastric cardia is notoriously difficult to evaluate on single-contrast barium studies because the overlying rib cage prevents manual compression of the gastric fundus. If the fundus is not adequately distended, gastric folds may obscure surface detail. If…
Mallory-Weiss Tear PATHOGENESIS A Mallory-Weiss tear is a linear mucosal laceration at or near the cardia caused by a sudden, rapid increase in intraesophageal pressure due to violent retching or vomiting after an alcoholic binge or protracted vomiting for any…