American Journal of Roentgenology, Vol 161, 335-337, Copyright © 1993 by American Roentgen Ray Society
Detection of rectal and pararectal varices in patients with portal hypertension: efficacy of transvaginal sonography
H Malde, A Nagral, P Shah, MS Joshi, SJ Bhatia and P Abraham
Department of Radiology, King Edward Memorial Hospital, Parel, Bombay, India.
OBJECTIVE. The appearance and frequency of pararectal varices in patients
with portal hypertension have not been studied. Accordingly, we used
transvaginal sonography to detect pararectal varices and to compare their
appearance and frequency with those of rectal varices in patients with
portal hypertension. SUBJECTS AND METHODS. Transvaginal sonography was
performed in 21 women with portal hypertension of different causes. The
frequency and appearance of pararectal varices were determined and compared
with those of rectal varices detected either in the same sonographic study
or by sigmoidoscopy. RESULTS. Pararectal varices were detected in 17 (81%)
of 21 patients. The varices varied in diameter from 2.1 to 5.5 mm (median,
3.5 mm). Seven of the patients with pararectal varices did not have rectal
varices. Rectal varices were detected in 10 of 21 patients by transvaginal
sonography and in nine patients by sigmoidoscopy; the two methods together
showed rectal varices in 13 patients. CONCLUSION. Transvaginal sonography
is useful for detecting pararectal and rectal varices in patients with
portal hypertension. Pararectal varices are more common than rectal varices
in these patients.