The stomach is a fascinating organ. It has the capacity to expand its volume substantially to receive and accommodate food after a meal, normally without any conscious notice of the expansion.
It mixes and grinds the food into small particles, it separates small particles from large particles, and it can discriminate between solids and liquid. After ingestion of irritant or toxic material, the stomach can reverse its normal activity to facilitate forcible ejection of gastric contents through the mouth. How can, what appears to be a simple muscular bag, carry out all of these functions? The answer is, of course, that the stomach is not a simple bag; it is a complex organ with different compartments that acts in concert to perform a range of highly specialised functions.
The aim of this presentation is to show how transabdominal ultrasonography can disclose the structural and functional secrets of the stomach. Ultrasound of the stomach was initially performed to detect and investigate organic diseases of the gastric wall. Subsequently, different methods were developed to study functional aspects of gastric pathology. Ultrasound can be used to evaluate antral contractility, gastric emptying, transpyloric flow, gastric configuration, intragastric distribution of meals, gastric accommodation and strain measurement of the gastric wall. Advanced methods for 3D ultrasound imaging and tissue Doppler (Strain Rate Imaging) have also been developed to study diseases of the stomach. For symptom provocation in dyspeptic patients, The Ultrasound Meal Accommodation Test (UMAT) can be applied to distinguish and characterize patients with organic versus non-organic dyspepsia.