Hypertrophied antral-pyloric fold: reassessment of radiographic findings in 40 patients.
OBJECTIVE
To reassess the findings of a hypertrophied antral-pyloric fold on double-contrast barium studies.


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.


CONCLUSIONS
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.
Arora
R
R
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.
Levine
M S
MS
Harvey
R T
RT
Laufer
I
I
Rubesin
S E
SE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006984:Hypertrophy; D008297:Male; D008875:Middle Aged; D011706:Pyloric Antrum / Q000000981:diagnostic imaging* / Q000473:pathology*; D011859:Radiography; D012189:Retrospective Studies