ENDOSONOGRAPHIC EVALUATION OF GIANT GASTRIC FOLDS

Giant gastric folds develop in several benign and malignant diseases. We used endoscopic ultrasonography to evaluate giant gastric folds in 15 patients with Borrmann type IV scirrhous carcinoma, 8 patients with gastric lymphoma, 5 patients with anisakiasis, 1 patient with Menetri er's disease, and 6 normal subjects with simple gastric hyperrugosity. With a 7.5 MHz transducer, a five-layered gastric wall structure was imaged, The thickness of the gastric wall and each layer was measured and compared with the endosonographic findings of 16 healthy subjects. Endoscopic ultrasonography findings revealed that the second layer al one was thickened in Menetrier's disease, and the third layer alone en larged in anisakiasis. Most of the patients with scirrhous carcinoma s howed an abnormally enlarged third and fourth layer, The second layer together with the third layer was thickened in healthy subjects with s imple hyperrugosity and also in patients with gastric lymphoma. Howeve r, the fourth ultrasound layer corresponding to the muscularis propria was significantly thickened only in malignant conditions. It is concl uded that endoscopic ultrasonography can visualize the structure of gi ant gastric folds and may facilitate the differentiation of benign fro m malignant etiologies.