Gastric antral web

Case contributed by Mohammad Taghi Niknejad
Diagnosis almost certain

Presentation

Dyspepsia and regurgitation.

Patient Data

Age: 50 years
Gender: Female

Upper GI series

Fluoroscopy
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Info

Barium passes through the esophagus and shows a normal mucosal pattern without filling defects or outpouching. No abnormality is noted in the esophagogastric junction. A small-sized sliding hiatal hernia is evident.

The stomach has a normal shape and mucosal appearance. A thin antral web is evident as a thin vertical filling defect causing mild antral narrowing.

The bulb and the duodenum are unremarkable.

Case Discussion

The gastric antral web, or the pre-pyloric mucosal diaphragm, is a rare ring of mucosa in the distal stomach that is often asymptomatic but may lead to gastric outlet obstruction. If the web is large, it may result in the appearance of a "double duodenum".

Symptomatic webs should be removed with upper endoscopy.

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