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American Journal of Roentgenology, Vol 142, Issue 6, 1121-1125
Copyright © 1984 by American Roentgen Ray Society

Articles

Computed tomographic recognition of gastric varices

EJ Balthazar, A Megibow, D Naidich, and RS LeFleur

The computed tomographic (CT) findings in 13 consecutive patients with proven gastric varices were analyzed and correlated with the radiographic, angiographic, and gastroscopic evaluations. In 11 patients, CT clearly identified large (five) or smaller (six) varices located mainly along the posteromedial wall of the gastric fundus and proximal body of the stomach. Well defined rounded or tubular densities that enhanced during intravenous administration of contrast material and could not be distinguished from the gastric wall were identified. Dense, enhancing, round or tubular, intraluminal filling defects were seen in the cases where the stomach was distended with water. In two patients, the CT diagnosis of gastric varices could not be confidently made. All patients had associated intraabdominal collateral circulation, situated medial to the stomach within the lesser omentum, along the distribution of the coronary venous system. In seven patients, the CT examination correctly diagnosed the pathogenesis of gastric varices by identifying hepatic cirrhosis, calcific pancreatitis, and carcinoma of the pancreas.
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