Abstract
Background and Aim: Abdominal ultrasonography is effective in the visualization of gastric wall layers and measuring its thickness. The study aimed to assess gastric antral wall thickness in patients with H. pylori gastritis by abdominal ultrasonography and to study its predictive value in detecting H. pylori gastritis. Materials and Methods: The study included ninety adult individuals, sixty of them had dyspepsia and/or upper abdominal pain and histologically confirmed gastritis, were distributed equally according to the H. pylori infection status into group A (H. pylori gastritis) or B (non-H. pylori gastritis), while, group C included thirty asymptomatic participants with negative H. pylori screening. The participants were subjected to abdominal sonography for measuring the antral wall thickness (AWT), mucosal wall thickness (MLT) and mucosal-to-antral wall thickness ratio (MLT/AWT ratio). Results: The AWT, MLT and MLT/AWT ratio were significantly greater in H. pylori gastritis group (5.65 ± 0.58, 3.02 ± 0.43, 0.53 ± 0.04 respectively) than non-H. pylori gastritis group (4.57± 0.82, 2.07± 0.41, 0.45 ± 0.02 respectively) and control group (3.93 ± 0.52, 1.49 ± 0.2, 20.37± 0.03 respectively). The optimal cut off values of AWT, MLT and MLT/AWT ratio for detecting the of H. pylori infection among symptomatic gastritis patients were > 4.94 mm, > 2.46 mm and > 0.48 mm respectively. Conclusion: Ultrasonography of the gastric antrum is considered beneficial in evaluating patients with presumed gastritis. The increase of AWT > 4.94 mm, MLT > 2.46 mm, and MLT/AWT ratio > 0.48 mm in patients with gastritis is suggestive of H. pylori infection.
Highlights
Gastritis is a mucosal inflammation, which could results in various clinical symptoms as nausea, vomiting, pain in the upper abdomen and feeling of fullness [1]
The antral wall thickness (AWT), mucosal layer thickness (MLT) and MLT/AWT ratio were greater in group A (H. pylori gastritis) than in group Band group C with p-value < 0.001, there was a significant increase in AWT, MLT and MLT/AWT ratio in H. pylori gastritis group when compared only with on-H. pylori gastritis group
Receiver operating characteristic (ROC) curve analysis of gastric wall thickness in H. pylori gastritis group showed that the optimal cut off values of AWT, MLT and MLT/AWT with the maximum sensitivity and specificity for detecting H. pylori infection among patients with symptomatic gastritis were > 4.94, > 2.64, > 0.48 respectively when it was compared with non-H
Summary
Gastritis is a mucosal inflammation, which could results in various clinical symptoms as nausea, vomiting, pain in the upper abdomen and feeling of fullness [1]. H. pylori infection (HPI) is the commonest cause of gastritis, other causes may be non-steroidal antiinflammatory drugs, autoimmune, bile reflux and alcohol intake [2]. Gastritis could be assessed by clinical, endoscopic, and histopathological examination [3,4,5]. The endoscopy is an invasive procedure and needs patient sedation; less invasive tests are favorable to decrease the number of endoscopic surveys [6]. The clinical outcome of HPI depends on both bacterial and patient factors. Abdominal ultrasonography is effective in the visualization of gastric wall layers and measuring its thickness. The study aimed to assess gastric antral wall thickness in patients with H. pylori gastritis by abdominal ultrasonography and to study its predictive value in detecting H. pylori gastritis
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