Abstract

HOURGLASS DEFORMITY OF STOMACH- A CASE REPORT

Dr. Arpitha S.*, Dr. Uma B. Gopal* and Dr. Simi C. P.*

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Abstract

Hourglass deformity of the stomach represents a distinctive anatomical alteration characterized by focal constriction of the gastric lumen, resembling an hourglass shape. This deformity can arise from various etiologies including gastric ulcers, tumors, benign strictures, and external compressive forces. Clinical manifestations typically include symptoms of gastric outlet obstruction such as early satiety, nausea, vomiting, and upper abdominal discomfort. Diagnosis involves a combination of imaging modalities such as contrast-enhanced CT scans and upper gastrointestinal series, alongside endoscopic evaluation for tissue sampling. The stomach, a key digestive organ, exhibits significant variability in shape and position influenced by muscle tone, body position, and respiratory phases. Clinically, it is classified into sthenic, hypersthenic, and hyposthenic types, each with distinct characteristics and ulcer risks. During a routine anatomical dissection at Sri Dharmasthala Manjunatheshwara College of Ayurveda and Hospital, Hassan, an hourglass deformity was discovered in the stomach of a 56-year-old male cadaver. This rare anomaly featured two prominent pouches connected by a narrow canal, measuring 22 cm in length. The pouches were nearly identical in size, with a 4 cm diameter canal linking them, caused by an unusual notch on the greater curvature. While many stomach shape variations are asymptomatic, they hold clinical significance. Previous studies have classified these anomalies into malrotated, herniated, and congenital categories. The hourglass deformity observed in this cadaver is considered congenital due to the absence of ulcer evidence at the constriction and no abnormal peritoneal bands. Unlike typical cascade stomachs, where the esophagus opens into the upper chamber, this case showed the esophagus opening into both pouches. Such anomalies, though often unnoticed, are crucial for radiologists to recognize to avoid misdiagnosis during barium meal radiographs. In conclusion, awareness of anatomical stomach variations, like the hourglass deformity, is vital for accurate diagnosis and effective clinical management.

Keywords: Hourglass deformity, Stomach, Greater Curvature.