Gastric fluid detected by sonography in fasting patients: relation to duodenal ulcer disease and gastric-outlet obstruction

Department of Radiology, St. Elisabeth's of Groote Gasthuis, Haarlem, the Netherlands.

We correlated the amount of gastric fluid identified by sonography in 143 fasting patients with the presence of duodenal ulcer disease and gastric-outlet obstruction as seen on barium studies. Unselected consecutive patients who were referred for a barium study of the upper gastrointestinal tract were included in a double-blinded prospective study. Sonograms were obtained in the right lateral decubitus position to allow gastric fluid to accumulate in the antrum, where it was quantified by measuring the maximal cross-sectional area of antral fluid in square centimeters. Sonograms revealed no fluid or a small amount (less than 5 cm2) in 87 (61%) of the patients and a large amount of fluid (greater than or equal to 5 cm2) in 56 patients (39%). Barium examinations showed a duodenal ulcer in 26 (46%) of the 56 patients with sonographic evidence of a large amount of gastric fluid compared with 10 patients (11%) in the group with little or no fluid on sonography (p = .001). Sonographic evidence of a large amount of fluid was found in all five patients who had gastric-outlet obstruction on barium examination (p = .02). The detection of a large amount of fluid in the stomach on sonography appears to be a feature of duodenal ulcer disease and gastric-outlet obstruction.
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