Comprehension: Stomach and Duodenum
Two prone PA projections of the stomach and duodenum are shown. In figure 1, the stomach is almost completely distended with a barium meal. Note the divisions of the stomach, including the cardia, fundus, body, and pyloric antrum. The cardia is adjacent to the esophageal junction with the stomach, and the fundus is the area superior to the cardia that fills with swallowed air in the upright position. Peristaltic waves can be seen on both the lesser and greater curvatures of the stomach. They can appear quite prominent when observed fluoroscopically. The pyloric canal is very short and is surrounded by the pyloric musculature. In figure 2, peristalsis has largely emptied out the lower aspect of the stomach and linear streaks of barium can be seen between the gastric rugae. In this figure the duodenum is well outlined. The first part of the duodenum (bulb) is usually at the level of L1, the second (descending portion) is at L2, the third portion crosses L3, and the fourth ascends to the ligament of Treitz on the left side of L2. In this patient the duodenum is shifted slightly to the right, however. The head and medial part of the body of the pancreas lie within the C-shaped loop. Mucosal folds in the duodenum and the jejunum vary from striations to irregular dark shadows in the barium.
