GREATER CURVATURE ANTRAL FLATTENING - A RADIOLOGIC SIGN OF NSAID-RELATED GASTROPATHY

We have occasionally encountered patients on nonsteroidal antiinflamma tory drugs (NSAIDs) in whom double contrast barium studies revealed pe rsistent flattening and stiffening of the distal greater curvature of the stomach. We therefore performed a study to determine the frequency of this finding in patients with NSAID-related gastropathy. Twenty-on e cases of erosive gastritis, gastric ulcers, and/or gastric scarring associated with a known history of NSAID use were reviewed by two radi ologists who made a joint decision regarding the presence or absence o f greater curvature antral flattening. This finding was seen radiograp hically in five of the 21 patients (24%). Four of the five patients wi th antral flattening had associated erosions or ulcers in the gastric antrum. The remaining patient had antral flattening as an isolated fin ding. Our experience suggests that flattening of the greater curvature of the distal antrum, particularly if associated with erosive gastrit is or gastric ulcers, is a useful radiologic sign of NSAID-related gas tropathy.