Gastric wall, normal

True congenital gastric diverticula are rare in children. All elements of the normal gastric wall are present and they can be regarded as incomplete gastric duplications. They are usually located posteriorly near the esophagogastric junction, are asymptomatic and can be seen on upper gastrointestinal studies when filled with contrast material (Elliot et al. 2006). 

The normal gastric wall is demonstrated as a five-layer structure. The first layer is hyperechoic, and corresponds to the luminal boundary and part of the mucosal layer. The second layer is hypoechoic and includes the remaining part of the mucosa and mucosal muscle layer. The third layer is hyperechoic and corresponds to the submucosal layer. The fourth layer is hypoechoic and corresponds to the proper muscle layer. The fifth layer is hyperechoic and corresponds to the serosa and the extramural boundary. 

Fig. 19.11. a Extramural compression of the gastric wall by the spleen. An elevated area due to compression of spleen is shown, b Endosonographic feature of the extramural compression by a liver cyst (/c). The normal live-layer structure is observed at the elevated area. Ao aorta... 

There are a variety of tumours which originate from supporting tissue components of the gastric wall, and which are mainly submucosal in distribution covered by normal mucosa. The most common are gastro-intestinal stromal tumours (GISTs) formerly known as leiomyomas and leiomyosarco-... 

TO no evidence of alteration of the gastric wall with normal fat plane... 

Conventional MRI 148 Endoscopic MR 148 MRI Appearances of Normal Gastric Wall 149... 

Ascariasis is the infestation of humans with the round worm, Ascaris lumbricoides. The adult worms normally live in the lumen of the small bowel of an infected individual. The eggs of the worm are passed in the faeces of these individuals and can contaminate water or food. Humans become infected when they ingest contaminated water or food. Gastric juices cause the eggs to hatch in the small bowel. The larvae penetrate the intestinal wall to enter the blood stream and reach the lungs. They migrate, or are carried by the bronchioles to bronchi, ascend the trachea to the glottis and pass down the oesopha-... 

Fig. 19.3. a Endoscopy of a gastric cyst. The lesion is located in the anterior wall of the antrum and is covered with normal mucosa without indentation or erosion, b Sonography with a convex probe (3 MHz) of the gastric cyst (gc). A small ane-choic lesion is demonstrated, although the main layer where it lies is not clear, c Scanning with a high-frequency linear probe (7 MHz) revealed that the lesion (gc) lies in the submucosal layer (sml). S stomach... 

Now we consider how the diagram is modiAed in a patient with persistent vomiting of gastric contents. Because of the loss of hydrochloric acid in the vomitus, the concentration of chloride in the plasma (falls, rises) and the amount of chloride Altered at the glomerulus is (more, less) than normal. The difference between the lengths of the chloride and sodium arrows is therefore (reduced, exacerbated). Consequently there will tend to be an (increase, decrease) in movement of HCOs", H", through the tubule wall in the directions of... 

Vitamin Bu, the antipemicious anemia factor, has the structural formula shown in Fig. 8. It is synthesized by bacteria and filamentous molds but not by animals or green plants. The vitamin was first recognized through studies of pernicious anemia, a disease in which the ability of the individual to absorb vitamin Bu is lost as a result of failure of the stomach to secrete a substance termed intrinsic factor. This substance is present in normal gastric juice and appears to be essential for the transport of vitamin B12 from dietary sources across the intestinal wall into the blood stream. Pernicious anemia is therefore the manifestation of a deficiency of vitamin Bu as caused by a failure to absorb the vitamin from the digestive tract. The disease, which occurs only in human beings, must be treated by injection of the vitamin, formerly obtained from liver extract and more recently from special fermentations. A deficiency of vitamin B12 may also arise from a lack of the substance in the diet, especially in the case of farm animals. 

An ulcer is a lesion on the wall of the stomach or small intestine. Under normal circumstances, a thick layer of mucus lines the stomach wall and protects it from the hydrochloric acid and other gastric juices in the stomach. If that mucous layer is damaged, however, stomach juices come in direct contact with the stomach wall and begin to digest it, creating an ulcer. The main symptom of an ulcer is a burning or gnawing pain in the stomach. 

Fig. 2. 13a,b. Early Gastric Cancer. Double Contrast barium study (a) shows slight distortion of normal mucosal folds on the posterior wall of the antrum of the stomach. Endoscopy (b) demonstrates the non-depressed lesion, with distortion of the normal gastric mucosal pattern. Histopathology confirmed early gastric cancer... 

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