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Hypertrophied Antral-Pyloric Fold: Reassessment of Radiographic Findings in 40 Patients¹

¹ From the Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104. Received December 23, 1998; revision requested March 9, 1999; revision received March 29; accepted June 9. Address reprint requests to M.S.L. (e-mail: levine@oasis.rad.upenn .edu).

PURPOSE: To reassess the findings of a hypertrophied antral-pyloric fold on double-contrast barium studies.

MATERIALS AND METHODS: A search of radiologic files resulted in recovery of records of 1,796 patients with findings of antral gastritis on double-contrast upper gastrointestinal studies. According to radiologic reports, 40 patients had a hypertrophied antral-pyloric fold. The radiographs were reviewed retrospectively to determine the size, location, and morphologic features of the folds. Clinical, radiologic, and/or endoscopic follow-up data were obtained in 22 patients.

RESULTS: All but two patients were symptomatic, and all but one responded to medical treatment. The hypertrophied antral-pyloric fold was located on the lesser curvature of the distal antrum in all patients and extended to the pylorus in 25 (62%) and into the base of the duodenal bulb in 15 (38%). The fold appeared as a smooth or slightly lobulated submucosal mass in 37 (92%) patients and as a plaquelike lesion in three (8%). Other radiographic findings of antral gastritis were present in 26 (65%) patients. In nine patients who underwent endoscopy, endoscopic and/or histologic findings of antral gastritis were present in five, but none had evidence of tumor.

CONCLUSION: A hypertrophied antral-pyloric fold may be a sign of antral gastritis that is associated with characteristic radiographic findings. Endoscopy and biopsy may not be warranted when lesions with features typical of a hypertrophied antral-pyloric fold are seen on double-contrast barium studies.

Index terms: Gastritis, 72.202, 72.291 • Helicobacter infection, 72.291 • Stomach, abnormalities, 72.91 • Stomach, inflammation, 72.202

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