atrophic gastritis
Atrophic gastritis is a chronic condition of autoimmune and non-autoimmune etiology.
Pathology
Two types of atrophic gastritis have been described :
- type A: autoimmune
- gastric body and fundus atrophy secondary to antiparietal cell antibodies
- decreased secretion of acid and intrinsic factor, with the latter leading to vitamin B12 deficiency
- type B: non-autoimmune (more common)
- gastric antrum atrophy secondary to Helicobacter pylori infection (most common), alcohol, NSAIDs, or bile salt reflux
Associations
- vitamin B12 deficiency
- pernicious anemia (megaloblastic)
- subacute combined degeneration of the cord
- gastric carcinoid tumors
Radiographic features
Fluoroscopy
Upper gastrointestinal fluoroscopic studies are non-specific but may demonstrate :
- decreased/absent fundal folds ('bald fundus')
- narrow tubular stomach (fundal diameter <8 cm)
- small/absent areae gastricae
Treatment and prognosis
Patients with atrophic gastritis are three times more likely to develop gastric cancer .
Differential diagnosis
- linitis plastica: this is usually nodular
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