The Pyloric Sphincteric Cylinder in Health and Disease



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Chapter 2 (page 5)

J.G. Moore et al (l986) described a midgastric transverse band in humans, which, in their view, represented an anatomic separation between the gastric reservoir (the fornix and corpus) and the antrum; the entire region between the transverse band and pylorus was considered to be the antrum. Collins et al. (1991) ascribed an important role to the transverse band in differential emptying of solids and liquids; it appeared to be responsible for the initial retention of solids. (It appears if the transverse band may correspond to the musculus sphincter antri, i.e. a loop at the termination of the oblique fibres of the muscularis externa, described by Torgersen in l942. It was also called the lower segmental loop and formed the oral boundary of the sinus.)

Discussion

One has to agree with Cunningham (1906), Forssell (1913) and Torgersen (1942) that the term "antrum" has been used in many different senses, that it is ambiguous and responsible for much of the obscurity associated with the pyloric part of the stomach. For instance, a number of authors equated "antrum" with the pyloric mucosal zone (Moe et al 1965; Strickland and Mackay 1973; Polak et al. 1977; Ryston et al. 1978; Dockray 1978; Ganong 1985), yet it has been shown that this zone is not constant and may migrate up and down the stomach in cases of gastric and duodenal ulceration (Chap. 5). Tanner (1964) mentioned the "extreme variability" in the extent of pyloric mucosa. In anatomy again, it has been stated categorically that the antrum is much smaller than the pyloric mucosal zone (Gray 1973).

Numerous other examples of conflicting views have been quoted above. It seems that the antrum may be errant or wandering in more ways than one, and that for this reason it is a designation which is best avoided.

References

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