April 15, 2011

Gastric Diverticulum

Fig. 1: Axial contrast-enhanced T1W MR image shows a mass (arrows) in the gastrohepatic ligament with internal low signal intensity, incidentally seen on the study performed for other reason in a young male.

Fig. 2: A coronal-reformatted CT image shows that the mass is filled with air and oral contrast material with a narrow communication (arrows) with the gastric lesser curvature.

Facts: Gastric Diverticulum
  • Incidence: 0.02% in autopsy studies, 0.04% on upper GI studies
  • True diverticula have complete wall, believed to be congenital. False diverticula are either traction or pulsion, and associated with inflammation or other diseases
  • True diverticula commonly arises from the posterior wall of the cardia, 2 cm below the EG junction or 3 cm from the lesser curvature.
  • Most are asymptomatic but they may cause epigastric pain, dysphagia, belching, bloating and early satiety.
  • Rare complications: bleeding, diverticulitis, perforation and cancer
  • Thin-walled, air-containing outpouching from the stomach. May contain fluid or gastric content
  • Size 1-5 cm, mostly less than 4 cm
  • If it is filled only with fluid, it can be difficult to differentiate from cystic tumor on cross-sectional imaging.
1. McKay R. Laparoscopic resection of a gastric diverticulum: a case report. JSLS 2005; 9:225-228.
2. Coakley F. Pearls and pitfalls in abdominal imaging: pseudotumors, variants and other difficult diagnoses. Cambridge University Press, 2010.

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