The Role of Conventional Ultrasonography in the Evaluation of Antrum Wall Thickness in Obese Patients.

Abstract

The objective of this study is to evaluate the utility of conventional ultrasonography (USG) in the evaluation of the stomach antrum and distal corpus lesions. A prospective evaluation was made of 69 patients who underwent sleeve gastrectomy. Preoperative USG was applied to the patients and measurements were taken and recorded of the stomach antrum full layer wall thickness (USGFT) and of mucosal thickness (USGMT). Postoperatively, same parameters were again measured histopathologically and the pathological full thickness (PFT) and pathological mucosal thickness (PMT) values were compared. When evaluation was made in respect of USG and pathological measurements, the USGFT was 8.51 ± 3.07 (range 4.5-15.8) and USGMT was 5.80 ± 2.15 (range 2.36-10.5). The PFT was determined as 8.13 ± 2.24 (range 4-14) and PMT as 5.53 ± 1.86 (range 2-10.5). In the histopathological examination, gastritis was seen in 53 (76.8%) patients and Helicobacter pylori (HP) positivity was determined in 32 (46.4%) patients. When the patients were grouped as obese (BMI ≤ 49.9kg/m2) (group 1, n = 50) and super obese (BMI ≥ 50kg/m2) (group 2, n = 19), no difference was determined between the groups ultrasonographically or histopathologically (p > 0.05). The antrum wall thickness was seen to be significantly greater in the patients with gastritis and HP positivity compared to the patients who were negative. In ROC analysis, cutoff values were calculated for USGFT (5.86mm) and USGMT (4.49mm). In gastritis diagnosis, the USGFT cutoff value was found to have 796% sensitivity and 68.7% specificity. USG was seen to be an extremely effective method in visualising the antrum wall and gastritis diagnosis can be made comfortably from the wall thickness measurement.