The fundus (from the Latin fundus, meaning bottom) is an anatomical part of the stomach.

Position. The fundus is one of the parts of the stomach (1). J-shaped pocket, the latter is located between the esophagus and the small intestine, and is divided into several zones:

• The cardia is the first area where the esophagus opens to the stomach.
• The fundus is located to the left of the cardia.
• The body makes up most of the stomach and is located between the cardia, fundus, and antrum.
• The cave forms the lower part of the stomach and opens into the pylorus.
• The pylorus and its region make up the last part of the stomach that connects to the small intestine.

Fundus structure. Dome-shaped, the fundus, also called large tuberosity, is the highest part within the stomach. The cardia and fundus form an acute angle, called the quadriceps incision (2) (3)

Wall. The wall of the stomach, including that of the fundus, is made up of different envelopes (4) (5):

• The mucous membrane is the inner layer that has different glands that secrete mucus, stomach acid, and gastric juices like digestive enzymes.
• The submucosa is the middle layer where various blood vessels and nerves circulate.
• The muscularis is the outer layer which is made up of three muscle layers. At the level of the fundus, this layer is quite thin (3).
• The serous membrane, or peritoneum, is an envelope lining the outer surface.

Vascularization and innervation. The vascularization of the stomach, including that of the fundus, is carried out by three nerve branches coming from the celiac trunk. They originate from both pneumogastric nerves and the great sympathetic nerve (6).

The peristalsis of the stomach corresponds to the muscular contractions allowing the advance of food within the stomach. These contractions start at the level of the fundus. Involved in this phenomenon, the fundus therefore allows food to advance within the body of the stomach to be stored there and then within the antrum to be stirred there (3).

Gastroesophageal reflux. Commonly known as heartburn, gastroesophageal reflux disease is an upward movement of stomach contents into the esophagus. The gastric juices contained in these lifts cause burning sensations as well as irritation in the esophagus.

Gastritis. It designates an inflammation of the internal lining of the stomach, including that of the fundus. This inflammation can be caused by taking certain medications or be linked to a bacterial infection. The development of bacteria can lead to a peptic ulcer (7).

Peptic ulcer. This pathology corresponds to the formation of a deep wound in the wall of the stomach or that of the duodenum. It manifests itself by sharp pains in the stomach. Peptic ulcer disease is often caused by bacterial growth but can also occur when taking certain medications (7).

Stomach cancer. Cancerous tumors can develop in the stomach, especially in the fundus (8).

Medical treatment. Depending on the pathology diagnosed, certain treatments may be prescribed such as antibiotics, or even antacids.

Surgical treatment. Depending on the pathology diagnosed and its evolution, a surgical intervention may be implemented.

Chemotherapy, radiotherapy or targeted therapy. Depending on the type and stage of the tumor, these treatments may be used to destroy cancer cells.

Physical examination. First, a clinical examination is performed to assess the symptoms.

Medical imaging exams. Depending on the suspected or proven pathology, additional examinations may be performed such as an ultrasound or an upper digestive endoscopy.

Biological examination. Blood tests can be done.

Biopsy. A sample of gastric cells may be taken to complete or confirm a diagnosis.

“Air pocket”. The fundus is also called an “air pocket” because the air swallowed while eating is concentrated in this part of the stomach (1).