What causes Carman Meniscus Sign in the stomach on barium imaging?
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The Carman Meniscus Sign is caused by a large, flat, infiltrative gastric ulcer, typically a malignant ulcerated neoplasm such as ulcerated gastric adenocarcinoma. This appears on barium imaging as a lenticular (lens-shaped) collection of contrast with the inner margin convex toward the gastric lumen. The lesion often involves the lesser curvature of the stomach (body or antrum) and is characterized by heaped-up ulcer margins.
Why is it called so?
It is named after Russell Daniel Carman, a pioneer in gastrointestinal radiology at the Mayo Clinic in the early 20th century, who first described this sign in the 1920s. The term โmeniscusโ derives from the Greek mฤniskos meaning crescent moon, reflecting the lenticular or crescent-shaped appearance of the barium trapped at the ulcer site.
Pathophysiology
The Carman Meniscus Sign develops due to compression of a flattened, infiltrative gastric tumor along the lesser curvature, which apposes the tumor surfaces and traps barium contrast between these margins during a single-contrast or biphasic barium study with applied external compression. This results in a semicircular or meniscoid configuration of the contrast that is convex toward the lumen. The inner marginโs convexity distinguishes malignant ulcers from benign ulcers where the margin is usually concave.
Alternative names: None
Other associated named signs: None
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