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Fundus of stomach

The fundus of the stomach is the rounded, dome-shaped portion of the stomach located superior to the cardiac orifice and above the level of the esophagogastric junction. It lies beneath the left hemidiaphragm and typically contains a small amount of swallowed air, forming the gastric air bubble seen on radiographs and CT. The fundus is continuous inferiorly with the body of the stomach and plays a role in accommodating food without a significant rise in intragastric pressure. Its mucosa contains gastric glands with parietal cells that secrete hydrochloric acid and intrinsic factor, and chief cells that secrete pepsinogen.

Synonyms

  • Gastric fundus

  • Dome of stomach

  • Fundic region

Function

  • Serves as a storage chamber for ingested food and air

  • Allows receptive relaxation to accommodate food without significant pressure increase

  • Contributes to mechanical and chemical digestion through gastric secretions

  • Produces acid and pepsinogen for protein digestion

  • Initiates the release of intrinsic factor for vitamin B12 absorption

Arterial Supply

  • Primarily supplied by the short gastric arteries, branches of the splenic artery

  • Additional supply from the left gastric artery and posterior gastric artery

Venous Drainage

  • Drains into the short gastric veins, which empty into the splenic vein

  • Contributes to the portal venous system

Nerve Supply

  • Parasympathetic fibers from the vagus nerve (CN X) via gastric branches stimulate motility and secretion

  • Sympathetic fibers from the celiac plexus inhibit gastric activity and constrict blood vessels

MRI Appearance

T1-weighted images:

  • Gastric fundus wall appears as a low to intermediate signal ring

  • Lumen may contain air (signal void, black), fluid (low signal), or food material

  • Surrounding fat is hyperintense, outlining the gastric contour

T2-weighted images:

  • Gastric wall appears intermediate to low signal intensity

  • Intraluminal fluid appears bright hyperintense

  • Pathology (edema, gastritis, tumor) may show focal or diffuse hyperintense thickening

STIR (Short Tau Inversion Recovery):

  • Suppresses fat, improving visualization of inflammatory changes or edema

T1 Post-Contrast (Gadolinium-enhanced):

  • Gastric wall enhances homogeneously in normal fundus

  • Tumors (adenocarcinoma, GIST) or inflammation show heterogeneous or asymmetric enhancement

  • Useful for detecting mucosal and submucosal lesions

CT Appearance

Non-contrast CT:

  • Fundus appears as a thick-walled, air- or fluid-containing structure beneath the left hemidiaphragm

  • Gastric air bubble is commonly seen

  • Wall thickening may indicate pathology

Contrast-enhanced CT (CECT):

  • Gastric wall enhances uniformly in normal cases

  • Excellent for evaluating tumors, varices, ulcers, perforations, and inflammatory changes

  • Demonstrates fundic relations with spleen, diaphragm, and left kidney

MRI images

Fundus of stomach anatomy MRI axial image -img-00000-00000

MRI images

Fundus of stomach anatomy MRI coronal image -img-00000-00000

CT image

Fundus of stomach anatomy CT axial image -img-00000-00000