Differential Diagnosis for Liminal Narrowing at Gastric Incisura Angularis
Single Most Likely Diagnosis
- Gastric stricture or stenosis: This is the most likely diagnosis given the history of gastric balloon removal and the presentation of liminal narrowing at the gastric incisura angularis. The balloon could have caused chronic irritation, leading to scarring and subsequent narrowing of the gastric lumen.
Other Likely Diagnoses
- Gastritis or ulceration: Inflammation or ulceration in the stomach, possibly exacerbated by the presence of the gastric balloon, could lead to narrowing at the incisura angularis due to edema or scar formation.
- Erosive gastritis: Similar to gastritis, erosive gastritis could cause localized damage and narrowing, especially if the gastric balloon caused mechanical irritation.
- Gastrointestinal dysmotility: Although less directly related to the physical presence of a balloon, dysmotility issues could contribute to or exacerbate narrowing by altering normal gastric emptying and causing chronic distension or irritation.
Do Not Miss Diagnoses
- Gastric cancer: Although less likely, gastric cancer could present with narrowing at the incisura angularis. It's crucial to rule out malignancy, especially in patients with risk factors or those who have not undergone recent screening.
- Ingested foreign body: If the narrowing is due to an obstructing foreign body, it would be critical to identify and remove it to prevent complications like perforation or severe obstruction.
- Caustic ingestion: If the patient had ingested caustic substances, it could lead to severe gastritis and stricture formation, which would need immediate attention.
Rare Diagnoses
- Scleroderma: This autoimmune disease can cause fibrosis in the gastrointestinal tract, leading to narrowing and dysmotility. However, it would be an uncommon cause of localized narrowing at the incisura angularis.
- Eosinophilic gastritis: A rare condition characterized by eosinophilic infiltration of the stomach wall, which could potentially cause narrowing due to inflammation and fibrosis.
- Crohn's disease: Although more commonly associated with the small intestine and colon, Crohn's disease can affect any part of the gastrointestinal tract, including the stomach, and cause strictures. However, gastric involvement is rare.