Details

Fig. 2.35 Shape of the body-antrum junction a Observe the typical tapering of the body toward the antrum

Fig. 2.35 Shape of the body-antrum junction a Observe the typical tapering of the body toward the antrum b The angulus marks the transition to the antrum

c The antrum is largely free of rugal folds

The endoscopic details of the body-antrum junction and antrum are reviewed below.

Body-antrum junction Shape

Marked tapering of the stomach is usually noted at the body-antrum junction (Fig. 2.35).

Topography

The typical curve of the angulus is visible in the distance. It provides a landmark for positively identifying the greater and lesser curves and the anterior and posterior walls. Surface

The gastric folds generally give way to smooth mucosa as you proceed from the body of the stomach to the antrum. In rare cases, folds are seen extending deep into the antrum. Mucosa

The mucosa at the body-antrum junction is reddish-orange, as in the body itself. Often it appears more red, and it may even have a somewhat patchy appearance.

Antrum Shape

The antrum has the shape of a dome with the pylorus at the apex (Figs. 2.36-2.38).

Topography

The greater and lesser curvatures and anterior and posterior walls are easy to identify after you have passed the angulus (Fig. 2.40). Surface

The prepyloric folds in the antrum have a highly variable appearance (Fig. 2.41). Mucosa

The antral mucosa is smooth and also highly variable in its coloration, which ranges from yellowish-gray to reddish-orange.

Fig. 2.36 Advancing toward the pylorus

Fig. 2.38 View of the pylorus in the antral dome. Circumferential biopsy samples have been taken. The radial pattern of blood tracks reflects the domelike shape of the antrum

re eu

3 CT

Fig. 2.37 Position of the antrum in left lateral decubitus. The dome of the antrum forms the highest point at which the insufflated air collects

Fig. 2.38 View of the pylorus in the antral dome. Circumferential biopsy samples have been taken. The radial pattern of blood tracks reflects the domelike shape of the antrum o (0

Fig. 2.39 Looping of the endoscope in the stomach

Fig. 2.39 Looping of the endoscope in the stomach

The insertion tube forms a deeply bowed loop along the greater curvature and antrum. After passing the pylorus, the tip is propelled into the duodenal bulb

Fig. 2.40 View of the angulus with a curved instrument. Notice that when the angulus region is sharply angled, the inlet and outlet of the stomach are oriented approximately in the same direction d = duodenum
Fig. 2.41 Variable appearance of the prepyloric region ■ 42

Was this article helpful?

0 0

Post a comment