Stomach Parts
The stomach has five anatomical regions from the gastro-oesophageal junction to the pylorus. Each region has distinctive mucosa, muscle, and clinical associations.
✦ The Mnemonic
"Careful Frogs Build Amazing Passages"
Cardia · Fundus · Body · Antrum · Pylorus — the five gastric regions
Clinical Breakdown
The stomach lies in the left upper quadrant, posterior to the left lobe of the liver and anterior to the lesser sac. The lesser curvature is supplied by the right and left gastric arteries; the greater curvature by the right and left gastroepiploic arteries and short gastric arteries.
Peptic ulcer disease: gastric ulcers are most common on the lesser curvature of the antrum and body junction. Duodenal ulcers (in the first part of the duodenum) are 4× more common than gastric ulcers overall. H. pylori is responsible for ~90% of duodenal ulcers and ~70% of gastric ulcers — eradication is the cornerstone of treatment.
Gastric cancer most commonly arises in the antrum and lesser curvature. It spreads via lymphatics (Virchow's node — left supraclavicular), transcoelomic (Krukenberg tumour — ovarian metastasis), and haematogenous routes. Sister Mary Joseph's nodule = umbilical metastasis.
⭐ Clinical Pearl
Pyloric stenosis in infants: hypertrophy of the pyloric muscle causes progressive projectile non-bilious vomiting at 2–6 weeks. Palpable 'olive' in the epigastrium. Electrolytes show hypochloraemic hypokalaemic metabolic alkalosis (loss of HCl + secondary aldosteronism). Definitive treatment: Ramstedt's pyloromyotomy.