Hourglass Stomach : Definition, Etiology, Signs, Symptoms, Diagnosis, & Management
- It occurs exclusively in women, is due to cicatricial contracture of lesser curve ulcer.
- Here stomach is divided into two compartments.
- Loss of periodicity
- Persistent pain
- Loss of appetite and weight
- Barium meal: It shows filling only in the proximal stomach or double pouched stomach.
- Partial gastrectomy wherein gastric ulcer with lower compartment of the stomach is removed and Billroth-I anastomosis is done.
Hourglass Stomach is usually seen as complication of gastric ulcer.
Daintree Johnson Classification
|Type I||In the antrum, near the lesser curve||55%||Normal|
|Type II||Combined gastric ulcer (in the body) with duodenal ulcer||25%||High|
|Type III||Prepyloric ulcer||15%||High|
|Type IV||Gastric ulcer in the proximal stomach or cardia||5%||Normal|
|Type V||Diffuse ulcer (due to NSAIDs)|
1. Hourglass stomach
2. Tea-pot stomach (Hand-Bag stomach)
- It is due to cicatrisation and shortening of the lesser curvature.
- They present with features of pyloric stenosis.
- Treatment is partial gastrectomy with Billroth-I anastomosis.
- Bleeding artery: Left gastric artery
5. Gastric outlet obstruction
- Posteriorly into pancreas, anteriorly into liver.
- Gastrectomy + Billroth anastomosis
- Partial gastrectomy + Billroth I : For gastric ulcer
- Gastrectomy + Billroth II : For distal gastric ulcer, duodenal ulcer
- Gastrectomy + Polya
Gastric Ulcer v/s Duodenal Ulcer
|Features||Gastric (Stomach) Ulcer||Duodenal Ulcer|
|Etiology||↓ mucosal resistence||↑ acid production|
|H. pylori association||75%||90%|
|Pain||Continuous, Increases on taking meal, More in lean & thin||Seasonal, Increases with hunger, Decreases on taking meal, More in obese|
|Complications||Perforations (most common), Bleeding (left gastric artery)||Bleeding (most common)(bleeding artery: gastroduodenal artery)|
|Haematemesis : Malaena||60:40||40:60|
|Weight||Weight loss||Weight gain|
|Treatment||Gastrectomy||Vagotomy & Drainage|
Disclaimer: Doctoralerts is an educational platform. It does not provide medical advice, diagnosis, or treatment. We neither promote nor sell any type of prescription drug or supplement.