GI - Bowel

Question 1

Thick rugal folds - stomach

Answer 1

Gastritis
- infectious (H pylori MC, if immunocompromised CMV / fungal)
- NSAID / caustic ingestion
- autoimmune / inflammatory / eosinophilic
- Menetrier’s (fundus; spares antrum)
- hypergastrinemia (ZES or enterochromaffin-like [ECL] gastric carcinoid)
Malignancy
- lymphoma
- carcinoma
- linitis plastica (primary or mets)
Crohn disease
Intramural hematoma
Sarcoidosis / amyloidosis
Mimics: gastric varices

Question 2

Ram’s horn deformity - stomach

Answer 2

Treated peptic ulcer disease
Granulomatous disease
- Crohn disease
- sarcoidosis
- TB
Scirrhous carcinoma (if diffuse: linitis plastica)

Question 3

Multiple intraluminal filling defects - stomach

Answer 3

Inflammatory / hyperplastic polyps
Hamartomatous polyps
- Peutz-Jeghers
- Juvenile polyposis 
- Cronkhite-Canada
Adenomatous polyps (usu. solitary but may be multiple, a/w atrophic gastritis)
Fundal gland polyps
- PPI use
- Familial adenomatous polyposis
Lymphoid hyperplasia
Mets

Question 4

Submucosal gastric mass

Answer 4

Mesenchymal tumour
- GIST
- other: fibroma, lipoma, neurofibroma
Carcinoid
Ectopic pancreatic rest (umbilicated submucosal nodule)