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Gastroscopy

Ive had 3 endoscopic procedures for Gerd in 9 years. Also a barium swallow 9 yrs ago. If in endoscopy for Gastritis the dr notices in the lower portion of the stomach (between antrum-body of stomach) looks like something is pushing it from yhe outside could it be a hernia? If so, can it be diagnosed through mri or u/s? P.s totally unsymptomatic and wasnt noticed in previous gi endoscopy
5 Responses
649848 tn?1534633700
Hi... Yes, it could be a hernia, or it could be something else, as well.  

Have you had any surgeries that might have left scars near/at the navel?  If so, it's possible there could be an incisional, also known as ventral, hernia.  You could also have a lipoma, a benign fatty tumor, which is quite common.  Rarely, one might get a cancerous tumor, called a Liposarcoma.  

Yes, these can "usually" be diagnosed via ultrasound or CT scan... the reason I say usually is because I just had a Lipoma that was misdiagnosed as a hernia.  It showed up as a bulge right beside my navel.  An ultrasound failed to indicate what it was, so a CT scan was recommended.  Even that was "hazy" since the bulge didn't correlate with either a hernia or a Lipoma; it only indicated that the bulge was not a solid mass so most likely not cancer.   I was sent to a surgeon who determined (don't ask me how because imaging certainly didn't back him up) that it had to be a hernia.  Because I was having pain, he recommended that it (hernia) be repaired, so surgery was scheduled.  

It turned out to be a large Lipoma instead of a hernia. The surgeon said the pain was probably caused by the Lipoma putting pressure on a nerve.  

I recommend that you ask for imaging to find out what you have and get appropriate treatment if needed.  If yours is totally inside so you can't feel anything on the outside, an ultrasound probably won't pick it up.  A CT scan, with contrast should tell them what it is.

They often don't do anything for a hernia if there's no pain or other symptoms. The same goes for a Lipoma - if it's not causing pain or other issues, there's a chance they won't do anything, but you know there's something there and you need to know what it is.

I hope this helps.
Avatar universal
Encountering extrinsic compression of stomach during endoscopy is common, and can be due to various causes, including normal variations in the shape/lobulations of adjacent organs (such as pancreas or liver), collections (such as pseudocysts), lymph nodes, or tumors.

It is unlikely that hernia is the cause of your specific situation. Ventral hernias can be in abdominal wall, but these typically bulge outward, not into your abdomen. Hiatal hernias slide from your abdomen up into your chest. There is such a thing as internal hernia, but this is a rare diagnosis, more often seen in patients with pri0r surgery such as gastric bypass surgery.

Pondering all these possibilities is more of an academic exercise. The more definitive way to answer your question is CT or MRI abdomen. US, while good in theory (less expensive, no radiation), often results in poor visualization of portions of the pancreas and limited sensitivity for lymph nodes, and you may end up having to get a CT or MRI anyway.
2 Comments
I asked for an mri and she refused. Should I consult another Gastroenterologist?
Hi, I did consult another Gi who suggested a U/S for a first action and upon that we will decide. So I am scheduled tomorrow for a 3D/4D u/s.
Avatar universal
It depends on what you will do with the ultrasound result. If the ultrasound comes back negative (i.e., no explainable cause), will you stop there? If you will stop there, then it is fine. If you are still going to get the MRI anyway no matter what, then there is really no point in getting the ultrasound since you are just wasting your time and money.
1 Comments
I thought about this myself. I guess my Gastroenterologist will advise next steps. I feel very upset and scared
Avatar universal
Sometimes it might be up to insurance company too. Perhaps your doctor has attempted to go straight to MRI in the past, and could not get authorization from the insurance company. So the only way is to get the US first.
1 Comments
I don't mind the MRI its the cat scan I am scared of
Avatar universal
Either MRI or CT can answer the question in your case. The CT is slightly better for evaluating the bowel, while the MRI is slightly better for evaluating the pancreas. If you cannot lie still or have claustrophobia, then CT is preferred over MRI.
1 Comments
I dont have a problen with claustrophobia at all!! Thank you
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