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Epigastric pain
Benign Gastric Ulcer

Gastric Ulcer

• Hampton’s line – smooth benign ulcer collar ulcer collar in profile
• Carman’s meniscus – malignant ulcer crater within contour of stomach seen in profile looks like a meniscus
• Kirklin complex – the irregular heaped up margins that surrounded the barium filled ulcer crater and separate it from the converging folds en face
• Cresecent sign – benign ulcer crater extends outside contour of stomach seen in profile looks like a crescent.
• Benign ulcer location is typically antral and lesser curvature
• Greature curvature ulcers are seen with NSAIDS
• Ulcers in cardia are suspicious for malignancy. Malignant ulcers can occur anywhere
• Most malignant ulcers are caused by adenocarcinoma. Other causes: leiomyosarcoma, lymphoma, met

Gastric Ulcerations/Erosions/Diverticuli
Benign
PUD – Risk -> cigarrettes, ASA, atrophic gastritis
Complications -> bleed, gastric outlet obstruction, perforation, penetration     
Gastric Erosions – Risk -> Etoh, ASA, NSAIDs, stress, trauma, Crohn, viral, XRT
Hormonal – ZE, HPT, steroids, Curling ulcer(burns)
GIST – Most common gastric submucosal tumor. May ulcerate, calcify, become exophytic. Cannot distinguish benign from malignant radiographically
Malignant
Adenocarcinoma
Lymphoma
GIST
Mets
Gastric Diverticula – typically near GE jx.