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Gastroscopy image: external compression of the stomach
This image shows a bulge caused by the stomach wall being pushed in from outside. This appearance can come from normal organs next to the stomach or from other structures.
Not every external compression means cancer. When needed, the cause is looked into with endoscopic ultrasound (EUS), CT or MRI.
What does external compression of the stomach mean?
During gastroscopy a bulge can sometimes be seen on the inner wall of the stomach, as if it had been pushed in from outside. This is called “external compression of the stomach”.
It may come not from the stomach itself but from an organ or structure around it.
Seeing external compression of the stomach does not necessarily mean there is a tumour or cancer.
Why does it happen?
External compression of the stomach can come about for different reasons:
- Liver or spleen: the normal anatomical position of these organs, or their enlargement, can press on the stomach.
- Pancreas: cysts or other growths in the pancreas can push the stomach wall in from outside.
- Masses in neighbouring organs: some benign or malignant growths can press on the stomach.
- Normal anatomical structures: sometimes normal organs nearby can also give the appearance of external compression at gastroscopy.
What are the symptoms?
Most patients have no complaints at all. External compression may be noticed by chance at a gastroscopy done for another reason.
If the compression is marked, some patients may have:
- Feeling full early after meals
- Bloating of the abdomen
- Nausea
- Discomfort or pain in the stomach area
How is the diagnosis confirmed?
Gastroscopy shows the inner surface of the stomach. However, it cannot always identify the cause of external compression.
When needed:
- Endoscopic ultrasound (EUS): examines the stomach wall and the organs around it in detail.
- Computed tomography (CT) or MRI: helps to assess the organs around the stomach and any possible masses.
These tests can show whether the external compression comes from a normal organ or from another structure that needs looking into.
Is treatment needed?
Not every finding of external compression needs treatment.
If it comes from a normal anatomical structure, there is usually no need for any procedure.
If a cyst, an enlarged organ or another disease is found, treatment is planned according to that cause.
When should you see a doctor?
If your gastroscopy report contains the phrase “external compression of the stomach”, you are advised to see a gastroenterologist.
Your doctor will look at your gastroscopy findings and any earlier imaging results and decide whether further tests are needed.
Remember: external compression of the stomach is not on its own the diagnosis of a disease. Most of the time there may be no serious problem. What matters is that the cause of the compression is properly assessed.
Sources
- Prof. Ali Tüzün İnce, MD — personal endoscopy archive