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Change of position of a stomach

Position of a stomach. Change. Normal the arch, a body, a corner, a sine of a stomach are placed in the left half of an abdominal cavity; pyloric part, a pyloric threshold, the pyloric channel, the gatekeeper — in the right half.
Being mobile and pliable body, the stomach can change the situation depending on the various reasons and first of all on change of position of the body investigated. Change position of a stomach is observed at situs inversus universalis when the stomach appears under the right dome of a diaphragm; at relaxation of the left dome of a diaphragm (an atrophy of muscle fibers) rises together with a diaphragm up.
The pregnancy and the reasons causing increase of intra belly pressure change position of a stomach; it adopts the cross provision.
Provisions of a stomach in a chest cavity are represented by a so-called "chest" stomach at which an obligatory component is shortening of a gullet.

Among a set of changes there are provisions of a stomach one of often meeting torsion (turn) of a stomach around a cross or longitudinal axis is (see fig. 1). The X-ray pattern depends on extent of turn of a stomach. Turn on a cross axis leads to the fact that the sine and pyloric part is displaced up and to the left, upper parts of a stomach are in normal anatomic situation, or they are lowered.

Изменение положения желудка
Fig. 1. Change of position of a stomach
and — a stomach excess, increase in retrogastralny space, the "forced" provision of a back wall of a stomach; — a stomach excess on a longitudinal axis

Research of a stomach with turn on a cross axis is characterized by projective summation of a shadow of its output department on an upper third of a body or on area of the arch. After filling of the arch and a body of a stomach a contrast agent goes not to the right, and to the left, and after that rises up in pyloric part which axis as a result of a tension of a duodenum is directed not up, and down.
In antral department the second gas bubble — ahead of and to the left of a gas bubble of a stomach appears. The large intestine holds usual position or rises together with big curvature of a stomach up.
Position of a stomach on a longitudinal axis is characterized by movement of a stomach on 180 °, at the same time in his body the cone-shaped narrowing leading to passability disturbance is defined; the sine of a stomach and pyloric part are placed to the left of a rachis. The picture does not happen stable, and during research the stomach can adopt the normal anatomic provision.
Disturbance of tonic function of a stomach, ventroptosis, relaxation of the muscular device, infiltration inflammatory and tumoral elements of small curvature and a back wall of a stomach, a pancreas or liver can be the reason of turn or torsion of a stomach.
It is observed at posttraumatic torsion of a stomach, a tumor of a stomach, a pancreas, liver, etc.
It is distinguished at roentgenoscopy and a X-ray analysis with use of a contrast agent, double, triple contrast study in vertical and horizontal position of investigated.

 
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