HAMPTON'S LINE

HAMPTON’S LINE

Q.Hampton’s line is noted in
a. base of rectal ulcer signifying its malignancy
b. base of oral mucosal ulcer signifying its malignancy
C base of esophageal ulcer signifying its benignancy
d.base of gastic ulcer signifying its benignancy





ANS:-----d ===HAMPTON'S LINE  is located in the base of gastric ulcer  and is vertually diagnostic of benign ulcer.

• Radiographic signs of gastric ulcers are described as to whether they are seen in profile or en face (straight on). 
• The en face radiographic signs of gastric ulcers are best seen on double-contrast barium studies and to a lesser extent on compression views in the single-contrast examination. 

• The primary sign of ulcer is a collection of barium on the dependent wall .
• If an ulcer is present on a nondependent surface or is not filled with barium, it may be demonstrated as a ‘ring’ shadow, with barium coating the edge of the ulcer crater. 

FEATURES OF BENIGN GASTRIC ULCER

1.SIZE:   Most benign gastric ulcers detected on double-contrast barium studies are 5–10 mm in size.
‘Giant’ ulcers (>3 cm) are almost always benign but have a higher rate of complications of bleeding or perforation.


2.SHAPE:Most benign ulcers are round or oval; some may have tear-drop or linear contour.

3.En face, a smooth mound of oedema is often seen surrounding the ulcer crater causing a circular filling defect. Radiating folds seen in healing ulcers should be smooth and symmetric and continue to the edge of the crater.

4.The presence of normal areae gastricae extending to the ulcer crater is a good sign of benignancy.

5.The classic description of a benign gastric ulcer refers to lesser curvature ulcers seen in profile. The ulcer, often referred to as the ‘ulcer niche’, projects beyond the lumen of the stomach .

 6.Hampton'line : A pencil-thin line of lucency, ‘Hampton's line’, is present crossing the base of the ulcer. This is believed to represent preserved gastric mucosa with undermining of the more vulnerable submucosa. This sign is not common, but is virtually diagnostic of a benign ulcer. 

7.Ulcer collar : 2–4 mm smooth rim of lucency noted at the base of the ulcer is termed the ulcer collar. This is a a sign of benignancy. When there is more visible oedema associated with an ulcer it forms an ulcer mound. The ulcer mound should be a symmetrical gently sloping mass.


GASTRIC  ULCERS

Findings	Benign	Malignant
Hampton's line	Present	Absent
Extends beyond gastric wall	Yes	No
Folds	Smooth, even	Irregular, nodular, may fuse
Associated mass	Absent	Present
Carman meniscus	Absent	Present
Ulcer shape	Round, oval, linear	Irregular
Healing	Heals completely	Rarely heals

REF:

Adam: Grainger & Allison's Diagnostic Radiology, 5th ed.