Gastroptosis

Case contributed by Assist/Prof Imran Khan Mahsood

Presentation

Gastric fullness, discomfort, and nausea after meal which only relieve on lying position. He is having an emaciated look.

Patient Data

Age: 25 years
Gender: Male

Barium meal

Barium

In the first image (upright position), the stomach is distended and its greater curvature lying well below superior iliac spines. No gastric emptying occurred as long as the patient was upright. 

In the second image (supine position), the stomach ascends with more than normal emptying and audible gurgling sounds.

Case Discussion

Patients having gastroptosis will most often present with abdominal discomfort, nausea, vomiting, and belching after taking meals. It is more common in females.

It is diagnosed by barium studies and is defined as the downward displacement of the stomach with the greater curve of the stomach partly projecting below the level of the iliac crests, in upright position. The cardiac end stays at its normal location. 

Additional findings may be present such as elongated stomach, delayed gastric emptying in upright position and stomach ascent in lying position with commencement of normal gastric emptying.

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