Cascade stomach

Case contributed by Mohammad Taghi Niknejad
Diagnosis certain

Presentation

Dyspepsia. Incidental finding.

Patient Data

Age: 60 years
Gender: Male

Upper GI series

Fluoroscopy

Barium passes through the esophagus and shows a normal mucosal pattern without filling defects or outpouching. No abnormality is noted in the esophagogastric junction.

The stomach is a cascade type, an anatomic variant that involves an angulation separating the fundus and body of the stomach without twisting around the gastric mesenteries.

The bulb and the duodenum are unremarkable.

Filling defects and outpouching are not seen.

Case Discussion

This case typically demonstrates a cascade stomach, also known as a cup-and-spill configuration. This anatomic variant involves an angulation separating the fundus and body of the stomach without twisting around the gastric mesenteries.

It is important to distinguish it from a volvulus and for surgeons to be aware of it when planning gastric surgery, particularly before a bariatric procedure.

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