Sonographic Detection of Metastatic Disease of the Pyloris

Adult pyloric stenosis may be associated with many diseases, including portal hypertension, cirrhosis, gastritis, acquired immunodeficiency syndrome (AIDS), anorexia nervosa, syphilis, leukemia, lymphoma, and primary and metastatic cancer. Therefore, it is important that the screening abdominal ultrasound examination include pyloric-antral evaluation in those patients presenting with nausea, vomiting, abdominal pain, and abnormal laboratory values. Irregularity or decreased echogenicity of the gastric wall should be noted. The gastric wall thickness should approximate the size of the common bile duct in comparison. Wall thickness of greater than 4-6 mm is abnormal and needs documentation and further diagnostic evaluation.