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

Siehe auch:

• Autoimmungastritis