The hypertrophied antral-pyloric fold

American Journal of Roentgenology (Impact Factor: 2.73). 10/1985; 145(3):547-9. DOI: 10.2214/ajr.145.3.547
Source: PubMed

ABSTRACT In 3.25% of 400 consecutive double-contrast upper gastrointestinal examinations, a prominent fold in the prepyloric gastric antrum that extends through the pylorus into the base of the duodenal bulb has been identified. Although the clinical significance of this fold is undetermined, endoscopic evaluation suggests it is a manifestation of chronic gastritis. This fold may simulate other entities, but can be distinguished by its characteristic features. Proper recognition may prevent unnecessary procedures such as endoscopy and biopsy.

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    ABSTRACT: We report a patient found to have a hypertrophied antral-pyloric fold on barium study, in whom CT demonstrated a smooth soft tissue mass on the anterior wall of the pre-pyloric antrum. When this finding is encountered on CT, a double-contrast upper GI study should be performed as the next diagnostic test. Endoscopy can probably be avoided if the barium study shows the typical findings of a hypertrophied antral-pyloric fold.
    British Journal of Radiology 06/1999; 72(857):505-6. DOI:10.1259/bjr.72.857.10505019 · 2.03 Impact Factor
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    ABSTRACT: To reassess the findings of a hypertrophied antral-pyloric fold on double-contrast barium studies. A search of radiologic files resulted in recovery of records of 1,796 patients with findings of antral gastritis on double-contrast upper gastrointestinal studies. According to radiologic reports, 40 patients had a hypertrophied antral-pyloric fold. The radiographs were reviewed retrospectively to determine the size, location, and morphologic features of the folds. Clinical, radiologic, and/or endoscopic follow-up data were obtained in 22 patients. All but two patients were symptomatic, and all but one responded to medical treatment. The hypertrophied antral-pyloric fold was located on the lesser curvature of the distal antrum in all patients and extended to the pylorus in 25 (62%) and into the base of the duodenal bulb in 15 (38%). The fold appeared as a smooth or slightly lobulated submucosal mass in 37 (92%) patients and as a plaquelike lesion in three (8%). Other radiographic findings of antral gastritis were present in 26 (65%) patients. In nine patients who underwent endoscopy, endoscopic and/or histologic findings of antral gastritis were present in five, but none had evidence of tumor. A hypertrophied antral-pyloric fold may be a sign of antral gastritis that is associated with characteristic radiographic findings. Endoscopy and biopsy may not be warranted when lesions with features typical of a hypertrophied antral-pyloric fold are seen on double-contrast barium studies.
    Radiology 12/1999; 213(2):347-51. DOI:10.1148/radiology.213.2.r99nv30347 · 6.87 Impact Factor
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    ABSTRACT: The purpose of this study was to characterize the radiographic findings of antral gastritis and to determine whether there are differences in the appearance of antral gastritis in patients with and without Helicobacter pylori infection. A search of radiology, endoscopy and pathology files revealed 90 patients with antral gastritis on double contrast upper gastrointestinal tract studies who had endoscopy with testing for H. pylori. The barium studies were evaluated to further characterize the findings of antral gastritis without knowledge of the H. pylori status of the patients or of the endoscopy or pathology findings. The radiographic findings of antral gastritis included thickened folds in 67 patients (74%), polypoid antral gastritis (a subset of patients with thickened folds) in 6 (9%), antral erosions in 21 (23%), enlarged areae gastricae in 14 (16%), crenulation of the lesser curvature in 4 (4%), mucosal nodularity in 2 (2%), a hypertrophied antral-pyloric fold in 2 (2%) and antral striae in 1 (1%). 43 patients (48%) with antral gastritis were H. pylori positive and 47 patients (52%) were H. pylori negative. Thickened folds were detected in 39 H. pylori-positive patients (91%) with antral gastritis vs 28 H. pylori-negative patients (60%) (p<0.001); polypoid gastritis in 6 H. pylori-positive patients (14%) vs 0 H. pylori-negative patients (p<0.05); enlarged areae gastricae in 14 H. pylori-positive patients (33%) vs 0 H. pylori-negative patients (p<0.0001); and antral erosions in 2 H. pylori-positive patients (5%) vs 19 H. pylori-negative patients (40%) (p<0.0001). Our experience suggests that antral gastritis caused by H. pylori infection is associated with characteristic features on double contrast studies (including thickened folds, polypoid gastritis and enlarged areae gastricae) and that this condition is rarely associated with antral erosions. Thus, radiologists can often suggest whether the patient's gastritis is caused by H. pylori on the basis of radiographic findings.
    British Journal of Radiology 10/2002; 75(898):805-11. DOI:10.1259/bjr.75.898.750805 · 2.03 Impact Factor
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