Ultrasound Pictures of "Impaired Gastric Emptying"

Clinical manifestations Impaired Gastric Emptying: Vomiting, epigastric pressure, weight loss, impaired gastric emptying.

Cause Impaired Gastric Emptying: Narrowing of the gastric outlet due to recurrent ulcers, extrinsic compression (pancreatic tumor, cysts, etc.), a previous vagotomy, or diabetic autonomic neuropathy (gastroparesis).

Diagnosis Imp aired Gastric Emptying: History; sonography; gastric intubation; endoscopy to identify the cause. May be supplemented by an upper GI series if necessary.

Sonographic findings Impaired Gastric Emptying:
x Stomach maximally distended by fluid
x Possible absence of peristalsis
x Internal echo pattern may be anechoic to hyperechoic, depending on the consistency of the contents, causing the stomach to become more isoechoic to its surroundings; may be mistaken for an upper abdominal mass.

ULTRASOUND PICTURES of a, b Gastric atony. a Extended left intercostal scan shows the gastric fornix (S) distended by fluid (no internal echoes). SV = splenic vein, PT = pancreatic tail. b Subcostal oblique scan in left lateral decubitus shows the distended stomach (S) and fundus (F). The wall layers are no longer visible.

Accuracy of sonographic diagnosis Impaired Gastric Emptying: Sonography shows a distended stomach prior to gastric intubation. Impaired gastric emptying can be positively established as the cause of an acute abdomen. When the stomach has been decompressed with an oro- or nasogastric tube, it appears empty on ultrasound.
“Ultrasound Pictures of Abdominal Pain Impaired Gastric Emptying”