Gastric Diverticula

The stomach is the least common site in the GI tract for diverticula to occur. The most common gastric form is a true diverticulum containing mucosa, submucosa, and muscularis propria and is typically caused by traction secondary to inflammation and scarring. Gastric diverticula are most commonly located just below the level of the GE junction on the posterior aspect of the gastric fundus (75%). These diverticula are usually not larger than 3 or 4 cm and rarely cause symptoms.

The second most common type is a "partial antral gastric diverticulum" (20%), a small 1-2 cm outpouching arising on the greater curvature of the distal gastric antrum. These are acquired and are pulsion diverticula protruding through the muscularis propria. Partial antral diverticula may result from a prior gastric ulcer.

The overall incidence of gastric diverticula is 1:600-2400 of UGI studies. Gastric diverticula are differentiated from ulcers by the absence of edema, mass, or wall rigidity.

Radiographic Findings: UGIS

• Luminal outpouching with a broad neck

• Normal mucosal pattern may be appreciated within the pouch

• Location: 75% near GE junction on posterior wall; 20% on greater curvature at the gastric antrum

• Defect changes size and shape during imaging (vs. an ulcer which is rigid)

A. UGIS upright view demonstrating a large outpouching from the gastric fundus near the GE junction. An air/fluid level is present within the diverticulum.

B. UGIS supine view from the same patient. Note the broad neck and normal mucosal pattern within the diverticulum.