Stomach

1. Introduction to Stomach Ultrasound 100%

Indications: Pain, Vomiting, Palpable Mass
Role in Pediatric vs Adult Evaluation
Real-Time Assessment of Motility and Wall Layers
Advantages and Limitations of Gastric Sonography

2. Anatomy of the Stomach 100%

Anatomical Regions: Fundus, Body, Antrum, Pylorus
Wall Layer Identification (5-Layer Pattern)
Adjacent Structures: Liver, Pancreas, Spleen
Vascular Supply and Lymphatic Drainage

3. Scanning Technique and Protocol 100%

Patient Preparation: Fasting, Fluid Ingestion
Transducer Selection: Curvilinear or High-Frequency Linear
Best Views: Epigastric, Left Hypochondrium, Intercostal
Dynamic Assessment: Peristalsis, Emptying, Real-Time Visualization

4. Normal Stomach Appearance 100%

Collapsed or Fluid-Filled Antrum
Five-Layer Gastric Wall Structure
Peristaltic Activity with Normal Motility
Air-Fluid Levels and Gastric Contents

5. Pathologies of the Stomach 100%

1. Inflammatory Conditions

Gastritis (Acute and Chronic)
Hypertrophic Gastritis
Peptic Ulcer Disease (PUD)
Inflammatory Gastric Edema (e.g., pancreatitis-related)
Portal Hypertensive Gastropathy (indirect features)

2. Obstructive and Motility Disorders

Hypertrophic Pyloric Stenosis (HPS)
Gastric Outlet Obstruction
Pylorospasm
Gastric Volvulus
Gastroesophageal Reflux (in neonates/infants)

3. Masses and Neoplasms

Gastric Carcinoma
Gastrointestinal Stromal Tumor (GIST)
Gastric Polyp
Linitis Plastica
Gastric Lymphoma
Gastric Leiomyoma

4. Congenital and Structural Abnormalities

Gastric Varices
Bezoars
Gastric Perforation (Indirect Signs)
Gastric Duplication Cyst
Gastric Volvulus
Gastric Diverticulum
Pneumatosis of Gastric Wall
Gastric Hematoma

5. Traumatic, Vascular, and Post-Surgical Changes

Gastric Hematoma (trauma or anticoagulation)
Gastric Ischemia or Infarction
Gastric Perforation (free peritoneal fluid/air suggestive)
Gastric Fistula (post-trauma or surgery)
Post-surgical Gastric Changes (gastrectomy, bypass)
Post-biopsy or intervention-related changes

6. Miscellaneous and Rare Conditions

Gastric Varices
Gastric Bezoars
Pneumatosis of Gastric Wall (rare)
Gastric Foreign Body
Infiltrative Diseases (e.g., amyloidosis, sarcoidosis)
Parasitic Infestation (e.g., anisakiasis – rarely seen)

6. Pediatric Applications 80%

Hypertrophic Pyloric Stenosis (HPS)
Gastroesophageal Reflux Evaluation
Gastric Foreign Body Detection
Duplication Cysts or Congenital Wall Anomalies

7. Advanced Imaging and Comparison 30%

Comparison with Upper GI Endoscopy
Use of Contrast-Enhanced Ultrasound (CEUS)
Role of CT and MRI for Gastric Masses
Limitations Due to Gas and Obesity

8. Case Studies and Quiz Section 0%

Gastric Wall Thickening Patterns
Pyloric Stenosis vs Pylorospasm
Mass vs Polyp vs Bezoar
Quiz on Stomach Ultrasound Interpretation