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Specimen Image

The gastric folds (or gastric rugae) are coiled sections of tissue that exist in the mucosal and submucosal layers of the stomach.[1] They provide elasticity by allowing the stomach to expand when a bolus enters it. These folds stretch outward through the action of mechanoreceptors, which respond to the increase in pressure.[2] This allows the stomach to expand, therefore increasing the volume of the stomach without increasing pressure.[2] They also provide the stomach with an increased surface area for nutrient absorption during digestion.[2] Gastric folds may be seen during esophagogastroduodenoscopy or in radiological studies.[3][4

Clinical significance[edit]

Thickening of the gastric folds may be observed by endoscopy or radiography and may aid in the differential diagnosis of many disease processes including:[3]

Gastritis

The folds become very thick due to inflammation.[7]

Peptic ulcer disease

Ulcers cause breaks in the mucosa and cause erosion of the sub-mucosa.

Zollinger-Ellison syndrome

Gastrin levels increase due to tumors, which cause an increase in the gastric fold size.[7]

Ménétrier's disease

The mucosa pits are in excess causing thickening of the folds.[7]

Carcinoma

Helicobacter pylori infection

Causes inflammation of the folds.

Gastric syphilis[8]

Cytomegalovirus

Mucosa change shape causing rugae enlargement.[9]

Sarcoidosis

Causes thickening of the folds.

Rack Number

Specimen Number
06