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Gastritis

Gastritis ultrasound case study

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Reporting Panel

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Stomach Pathology

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USG

Gastritis ultrasound case study

CASE–1

Clinical History

A 42-year-old patient presented with recurrent epigastric pain, burning sensation, dyspepsia, nausea, early satiety, and postprandial discomfort. The patient was referred for abdominal ultrasound to evaluate upper abdominal pain and exclude hepatobiliary or pancreatic pathology.

Ultrasound Findings

Ultrasound examination demonstrates mild diffuse circumferential thickening of the gastric antral wall with preserved mural stratification and mild mucosal edema. The stomach contains a small amount of fluid. No focal gastric mass, ulcer crater, perigastric collection, gastric outlet obstruction, or free intraperitoneal air is identified. The liver, gallbladder, pancreas, spleen, and biliary tree appear unremarkable on the current examination.

Ultrasound of the stomach. Mild diffuse thickening of the gastric antral wall with preserved mural stratification and mild mucosal edema is demonstrated. These sonographic findings are suggestive of gastritis in the appropriate clinical setting.

Report Line

Mild diffuse circumferential thickening of the gastric antral wall with preserved mural stratification and mild mucosal edema is noted. No focal gastric mass, perigastric collection, gastric outlet obstruction, or free intraperitoneal air is identified. Sonographic findings are suggestive of gastritis.

Impression

Features are suggestive of mild gastritis involving the gastric antrum. No sonographic evidence of gastric perforation or other acute upper abdominal abnormality is identified.

Recommendation

Clinical correlation with symptoms and laboratory findings is recommended. Upper gastrointestinal endoscopy is advised for definitive evaluation and to assess for gastritis, peptic ulcer disease, or other mucosal pathology. Correlation with Helicobacter pylori testing is recommended where clinically indicated. Medical management with acid suppression therapy should be guided by the treating physician.

Key Learning Points

• Ultrasound has limited sensitivity for diagnosing gastritis because it cannot directly evaluate the gastric mucosa.
• Mild gastric wall thickening with preserved mural stratification may be seen in inflammatory gastritis but is nonspecific.
• The normal distended gastric wall measures approximately 3–5 mm; greater thickness may indicate inflammation or other pathology.
• Upper gastrointestinal endoscopy is the gold standard for diagnosing gastritis and obtaining biopsy when required.
• Helicobacter pylori infection is a common cause of chronic gastritis.
• Ultrasound is primarily valuable for excluding hepatobiliary, pancreatic, or other upper abdominal diseases presenting with similar symptoms.
• Persistent pain, gastrointestinal bleeding, anemia, weight loss, or recurrent vomiting should prompt early endoscopic evaluation.