Specific Disease States at the Base of the Stomach

Description

Centered in the upper abdomen, the male stomach is opened to emphasize the gastric base (fundus and adjacent cardia) with focal mucosal abnormalities along the rugal folds. Superiorly the fundus abuts the left hemidiaphragm, while the gastroesophageal junction sits posteromedial to the left lobe of the liver and inferior to the heart and basal lungs behind the rib cage. Laterally the greater curvature arcs toward the spleen, and inferior continuity toward the antrum and proximal duodenum is suggested by the adjacent intestinal loops. Fundal and cardial mucosa are common sites where clinicians must sort benign inflammation from lesions that change management. A raised or ulcerated fundal defect raises a different differential than an antral ulcer, including gastric malignancy in the proximal stomach, Cameron lesions in large hiatal hernia at the cardia, and fundal varices from portal hypertension that can produce brisk upper gastrointestinal bleeding. Orientation to this region also matters in operative planning because the short gastric vessels run in the gastrosplenic ligament along the superolateral fundus, and inadvertent injury can complicate splenectomy, Nissen fundoplication, or sleeve gastrectomy. Use this artwork for teaching stomach topography and proximal gastric pathology in preclinical gastrointestinal blocks, gross anatomy lab review, and pathology modules that pair gross findings with endoscopic correlation. It also reads well in surgical texts discussing approaches to the proximal stomach and in gastroenterology materials explaining why fundal lesions behave differently from antral disease. Anatomical accuracy verified by SciePro's Medical Advisory Board.