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Video Endoscopic Sequence 1 of 14.
Hourglass Stomach.
This 62 year-old female, have been presented with severe
abdominal pain since two months, in addition to the ulcer,
she has choledocolitiasis and a big abdominal hernia.
For more endoscopic details download the video clips by
clicking on the endoscopic images, wait to be downloaded
complete then press Alt and Enter; thus you can observe
the video in full screen.
All endoscopic images shown in this Atlas contain
video clips.
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Video Endoscopic Sequence 2 of 14.
Endoscopic Image of Hourglass Stomach.
Hourglass Stomach a stomach more or less completely
and permanently divided into two parts, so that it
resembles an hourglass in shape; the deformity is due to
scarring which complicates gastric ulcer or neoplasia.
A deformity of the stomach in which the ‘waist’ is
constricted by fibrosis caused by a chronic peptic ulcer,
producing an upper and a lower cavity separated by a
narrow channel.
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Video Endoscopic Sequence 3 of 14.
Retraction of the gastric wall adjacent to lesser-curve
ulcers may lead to the formation of smooth, symmetric folds
that radiate from the ulcer crater. The opposite wall may
also be retracted; this produces an incisura of the greater
curvature and, ultimately, an hourglass stomach.
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Video Endoscopic Sequence 4 of 14.
Hour-Glass Contraction
The image and the video clip show retraction of the gastric
walls, therefore giving us the formation of an invagination.
With little of resistance, the endoscope, it is advanced
to the antrum.
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Video Endoscopic Sequence 5 of 14.
Endoscopy of Hourglass Stomach.
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Video Endoscopic Sequence 6 of 14.
Due to the retraction of the gastric wall, to overcome some
difficulties, some maneuver to look the pylorus were
achieved.
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Video Endoscopic Sequence 7 of 14.
Follow up endoscopy.
After four days of treatment with lanzoprazol 30 mg twice a
day, a follow up endoscopy was performed.
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Video Endoscopic Sequence 8 of 14.
In spite of a short treatment of four days with PPI´s, there
are generative epithelium and less resistance to the
passage of the endoscope through narrowness.
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Video Endoscopic Sequence 9 of 14.
Hourglass Stomach.
A close up of generative epithelium at the border of the
ulcer, magnifying image.
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Video Endoscopic Sequence 10 of 14.
Hourglass Stomach.
A close up of generative epithelium at the border of the
ulcer, magnifying image.
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Video Endoscopic Sequence 11 of 14.
Chromoendoscopy using indigo carmine.
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Video Endoscopic Sequence 12 of 14.
High-resolution chromoendoscopy.
Chromoendoscopy, the intravital staining of
gastrointestinal. epithelia, provides additional diagnostic
information with respect to the epithelial morphology and
pathophysiology. Based on experience gathered,
chromoendoscopy is now in more widespread use, in
particular to identify preneoplastic and neoplastic lesions.
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Video Endoscopic Sequence 13 of 14.
More images and video clips of Hourglass Stomach with
indigo carmin stain.
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Video Endoscopic Sequence 14 of 14.
Chromoendoscopy.
Is a technique used to study the fine details of the mucosa
throughout the gastrointestinal tract.
Chromoendoscopy combines high resolution endoscopy
with various methods of vital staining of epithelial
structures. In these methods, during endoscopy, tissues
are coloured by a stain introduced through a spray
catheter. The staining techniques are technically simple,
economical and easy to perform.
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Video Endoscopic Sequence 1 of 10.
Hourglass Stomach.
This 67 year-old woman, presented with abdominal pain,
nausea and vomiting, endoscopy displays an image that
divided the stomach into two parts due to retraction of the
gastric wall.
Ulcers may lead to the formation of smooth, symmetric
folds that radiate from the ulcer crater. The opposite wall
may also be retracted; this produces an incisura of the
greater curvature and, ultimately, an hourglass stomach.
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Video Endoscopic Sequence 2 of 10.
Healing of antral ulcers is associated with narrowing and
deformity that may mimic malignancy. The hourglass
stomach results from the healing of a lesser-curve ulcer
and marked retraction or deformity of the opposite wall.
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Video Endoscopic Sequence 3 of 10
Hourglass deformity caused by fibrosis. This ulcer is
healing, with fibrosis dividing the body of the stomach into
2 compartments.
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Video Endoscopic Sequence 4 of 10.
A follow up endoscopy was performed after two months of PPI treatment.
View from retroflexed image.
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Video Endoscopic Sequence 5 of 10.
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Video Endoscopic Sequence 6 of 10.
The biopsies ruled out malignancy, a follow up endoscopy
was performed finding complete resolution of this process.
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Video Endoscopic Sequence 7 of 10.
After two months of PPI treatment a follow up endoscopy
was performed finding the images and videos presented
here, (retroflexed image).
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Video Endoscopic Sequence 8 of 10.
There are less retractable wall and multiple scars
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Video Endoscopic Sequence 9 of 10.
More images and video clips
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Video Endoscopic Sequence 10 of 10.
A stomach with an equatorial constriction usually caused by formation of scar tissue around an ulcer.
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Video Endoscopic Sequence 1 of 5.
Hourglass Ulcers constriction at the proximal gastric
corpus.
A 42-year-old alcoholic man, with a history of vomiting and
abdominal pain, presented hematemesis. A failed upper
endoscopy was performed at a Public Hospital, which it was
given diagnose of an obstructive stomach.
We performed an upper endoscopy observing red blood
remains and signs of Mallory Weiss Syndrome, which it
was treated with Plasma Argon Coagulator.
After maneuvering, we were able to
overcome the obstruction at the gastric body. Hourglass
ulcers constriction was observed which causes the
obstruction.
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Video Endoscopic Sequence 2 of 5.
Hourglass stricture of the proximal gastric corpus.
The image and the video display a proximal hourglass
stricture of the gastric corpus.
The video clip displays resistance to pass the endoscope
through the stenosis.
Retraction of the gastric wall adjacent to lesser-curve
ulcers may lead to the formation of smooth, symmetric folds
that radiate from the ulcer crater. The opposite wall may
also be retracted; this produces an incisura of the greater
curvature and, ultimately, an hourglass stomach.
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Video Endoscopic Sequence 3 of 5.
Another image and video of this endoscopic sequence.
The antrum is observed with diffuse redness and rest of
blood.
Occasionally, a gross horizontal fibrous contracture in
association with long-standing ulceration can cause a
permanent hourglass constriction, or the lesser curvature
can shorten longitudinally.
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Video Endoscopic Sequence 4 of 5.
The pre-pyloric antrum.
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Video Endoscopic Sequence 5 of 5.
A Mallory Weiss tear was found, and argon plasma
coagulator APC was used to the point of bleeding.
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Video Endoscopic Sequence 1 of 4.
Hourglass Stomach.
This 72 year-old female, underwent this upper endoscopy due to abdominal pain, nauseas and vomiting.
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Video Endoscopic Sequence 2 of 4.
Endoscopy of Hourglass Stomach.
Hourglass stricture or stenosis of stomach
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Video Endoscopic Sequence 3 of 4.
The retroflexed image show one of the ulcers
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Video Endoscopic Sequence 4 of 4.
3 Ulcers are seen
In this Endoscopic image there are three ulcers which
perhaps was at first a single ulcer healing and has caused
extensive fibrosis retracting the tissue and dividing the
stomach into two parts.
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