IV. The Radiological Features of Pernicious Anaemia

Unusual gastrointestinal features in a child with pernicious anemia

“…The mucosal atrophy (Fig. 2) which was shown in this child with pernicious anemia is a well-recognized finding in adults with the disease [1]. It is k n o w n that there is a good correlation between histologic and radiologic gastric atrophy [2], and in our patient, endoscopy and biopsy corroborated the abnormal mucosa demonstrated radiologically.…”

Radiological appearances in achlorhydria

“…Only three patients had radiological gastric atrophy by the criteria of Laws and Pitman (1960), all with histamine-fast achlorhydria and including only one patient with pernicious anaemia (Table II). However, consideration of the combined presence of only two features, 'bald fundus' and 'tubular outline', increased the diagnostic specificity for radiological evidence of achlorhydria from 12-5 to 33 %, without including any false positives.…”

“…The barium meal films were reviewed at random by one of us who was unaware of the clinical particulars. The four criteria of Laws and Pitman (1960) were sought, together with the additional two described by Joske and Vaughan (1962), namely, tubular shape, small volume, bald fundus, tissue paper folds, H-bomb sign, and disappearing mucosal folds. Each sign was recorded as being either present or absent, and in order to avoid false positives, criteria were considered present only when they appeared unequivocal.…”

“…Each sign was recorded as being either present or absent, and in order to avoid false positives, criteria were considered present only when they appeared unequivocal. A final opinion as to the existence of radiological gastric atrophy was based on at least three of the features of Laws and Pitman (1960) being present. The original barium meal investigations had been carried out by several radiologists.…”

“…More recently, the importance of the absence of, or diminished height and number of, the gastric rugae has been re-emphasized (Bock, Kemp, and Richards 1963). Laws and Pitman (1960) diagnosed radiological atrophy in 38 of 71 patients with pernicious anaemia from the presence of any three out of the FIG. 1. Radiographs demonstrating the characteristic features of radiological atrophy and indicative of histamine-fast achlorhydria, namely, 'baldfundus' and 'tubular shape', with loss of the greater curvature folds when distended.…”