What is the cause of hourglass syndrome, characterized by stomach sucking in?

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Last updated: April 8, 2025View editorial policy

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Differential Diagnosis for Hour Glass Syndrome Sucking in Stomach

  • Single most likely diagnosis:
    • Gastric volvulus or diaphragmatic eventration: This condition involves the stomach twisting upon itself, which can cause the appearance of an "hour glass" stomach on imaging. The sucking in of the stomach could be due to the abnormal positioning and twisting of the stomach.
  • Other Likely diagnoses:
    • Hiatal hernia: A condition where part of the stomach pushes up into the chest through an opening in the diaphragm, which could cause the stomach to appear sucked in.
    • Gastric outlet obstruction: A blockage at the end of the stomach that prevents food from entering the small intestine, potentially causing the stomach to appear distorted or sucked in.
    • Diaphragmatic hernia: A birth defect where there is a hole in the diaphragm, allowing abdominal organs to move into the chest cavity, which could affect the stomach's position and appearance.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
    • Gastric perforation: A hole in the stomach wall, which is a medical emergency. Although less likely, the symptoms could be misinterpreted as the stomach being sucked in.
    • Intestinal obstruction: A blockage that prevents normal flow of the products of digestion, which could lead to severe complications if not promptly treated.
    • Diaphragmatic rupture: A tear in the diaphragm, which could allow abdominal organs to enter the chest cavity and cause severe respiratory and cardiac complications.
  • Rare diagnoses:
    • Eventration of the diaphragm: A rare congenital condition where there is a weakness or thinning of the diaphragm, which could cause the stomach to appear sucked in due to abnormal diaphragmatic movement.
    • Congenital diaphragmatic anomalies: Other rare birth defects affecting the diaphragm, such as diaphragmatic agenesis or hypoplasia, which could impact the positioning and appearance of the stomach.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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