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January 1, 1982

Progressive Antral Narrowing in an Adolescent

JAMA. 1982;247(1):73-74. doi:10.1001/jama.1982.03320260051033

History  A 13-year-old girl with anorexia nervosa had severe nausea and vomiting. The findings from physical and laboratory examination were normal. Representative films from upper gastrointestinal (GI) tract series performed on the day of admission (Fig 1), at three weeks (Fig 2), and at eight weeks (Fig 3) after admission are illustrated.

Diagnosis  Corrosive gastritis.

Comment  Figure 1, a spot film from the patient's first upper GI tract examination, demonstrated mild antral narrowing associated with irregular shaggy mucosa. At fluoroscopy, poor contractility of this region was noted. The esophagus, duodenum, and small bowel were normal. Double-contrast gastroduodenal studies performed three weeks (Fig 2) and eight weeks (Fig 3) later showed progressive, tubular narrowing of the antrum. Such dramatic antral narrowing in a young patient with psychological problems should strongly suggest the diagnosis of corrosive gastritis. Only on close questioning did this patient admit ingestion of several mouthfuls of a cleaning