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Duodenogastritis

Duodenogastritis ultrasound case study

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Duodenogastritis ultrasound case study

CASE–1

Clinical History

A 45-year-old patient presented with recurrent epigastric pain, postprandial fullness, nausea, bilious vomiting, dyspepsia, and upper abdominal discomfort. The patient was referred for abdominal ultrasound to evaluate the stomach and proximal duodenum and to exclude other hepatobiliary or pancreatic pathology.

Ultrasound Findings

Ultrasound examination demonstrates mild circumferential wall thickening involving the gastric antrum and proximal duodenum with preserved mural stratification. Mild mucosal edema is noted. The stomach contains a small amount of fluid with echogenic intraluminal contents suggestive of bile reflux. No focal mass lesion, ulcer crater, perforation, perigastric collection, or gastric outlet obstruction is identified. The liver, gallbladder, pancreas, and biliary tree appear unremarkable on the current examination.

Ultrasound of the stomach and proximal duodenum. Mild circumferential wall thickening with preserved mural stratification involving the gastric antrum and proximal duodenum, along with echogenic intragastric bile reflux, is suggestive of duodenogastritis.

Report Line

Mild circumferential wall thickening involving the gastric antrum and proximal duodenum with preserved mural stratification and mild mucosal edema is noted. Echogenic intragastric contents are suggestive of bile reflux. No focal gastric or duodenal mass, perforation, perigastric collection, or gastric outlet obstruction is identified. Sonographic findings are suggestive of duodenogastritis.

Impression

Features are suggestive of duodenogastritis with mild inflammatory thickening of the gastric antrum and proximal duodenum, associated with probable bile reflux.

Recommendation

Clinical correlation with upper gastrointestinal symptoms is recommended. Upper gastrointestinal endoscopy is advised for definitive evaluation of gastritis, duodenitis, bile reflux, or peptic ulcer disease. Correlation with Helicobacter pylori testing and appropriate medical management is recommended. Contrast-enhanced CT abdomen may be considered if symptoms persist or complications are suspected.

Key Learning Points

Duodenogastritis refers to inflammation involving the gastric antrum and proximal duodenum, frequently associated with bile reflux.
Ultrasound may demonstrate mild wall thickening and mucosal edema but has limited sensitivity for evaluating mucosal disease.
Echogenic intragastric fluid may suggest reflux of bile into the stomach.
Upper gastrointestinal endoscopy remains the gold standard for diagnosing gastritis and duodenitis.
Helicobacter pylori infection, bile reflux, NSAID use, and alcohol are common etiological factors.
Ultrasound is primarily useful for excluding hepatobiliary, pancreatic, or other upper abdominal pathology that may mimic gastritis.
Persistent symptoms, gastrointestinal bleeding, weight loss, or anemia warrant prompt endoscopic evaluation.