PURPOSE: To demonstrate the clinical usefulness of ultrasonography for detecting esophageal varices. MATERIALS AND METHODS: In 20 cases of esophaged varix, the authors analysed the transabdominal ultrasono-graphicfindings of the esophagogastric junction and compared mural thickness, the anteroposterior diameter of theesophagus, and the echogenic nature of the esophageal mucosal layer with those of 78 normal patients. RESULTS:The anterior and posterior mural thickeness of normal esophagus was 2.2 +/-0.7 and 2.4 +/-0.8mm re-spectively, butfor variceal esophagus, the corresponding readings were 5.9 +/-1.3 and 5.2 +/-1.3mm respective-ly. Theanteroposterior diameter of normal esophagus was 7.9 +/-2.1mm and that of variceal esophagus was 1 4 . 0 +/-1.8mm.There was a stastically significant difference (p<0.01) in mural thickness and anteroposterior diameter of theesophagus between a normal and variceal patient with regard to change of echogenic nature at the esphagogastricjunction. Normal esophageal mucosa showed a thin and uniform echogenic line, but for variceal mucosa, theechogenic pattern was irregular, tortuous and thick. CONCLUSION: The athors believe that transabdominal US ishelpful for detecting esophageal varices in patients with liver cirrhosis and UGI bleeding. Important clinicallyuseful sonographic findings in diagnosing e-sophageal varix are as follows: 1) mural thickness more than 6mm; 2)anteroposterior diameter of the esopha-gus of more than 15mm; 3) irregular, tortuous and thickened echogenicmucosa.
Esophageal and Gastric Varices* ; Esophagogastric Junction ; Esophagus ; Hemorrhage ; Humans ; Liver Cirrhosis ; Mucous Membrane ; Reading ; Ultrasonography ; Varicose Veins

PURPOSE: To evaluate the diagnostic value of a lateral view of the ankles in Achilles tendon rupture. MATERIALS AND METHODS: We performed a retrospective analysis of the roentgenographic findings of 15 patients withsurgically proven Achilles tendon rupture. Four groups of 15 patients(normal, ankle sprain, medial lateralmalleolar fracture, and calcaneal fracture) were analysed as reference groups. Plain radiographs were reviewedwith regard to Kager's triangle, Arner's sign, Toygar's angle, ill defined radiolucent shadow through theAchilles tendon, sharpness of the anterior margin of Achilles tendon, and meniscoid smooth margin of the posteriorskin surface of the ankle. RESULTS: Kager's triangle was deformed and disappeared after rupture of theAchilles tendon in nine patients(60%) with operative verification of the rupture, six patients(40%) had a positiveArner's sign, while none had a diminished Toygars angle. In 13 patients(87%) with a ruptured Achilles tendon,the thickness of this was nonuniform compared with the reference group. The anterior margin of the Achilles tendonbecame serrated and indistinct in 14 patients(93%) in whom this was ruptured. An abnormal ill defined radiolucentshadow through the Achilles tendon was noted in nine patient(60%), and nonparallelism between the anterior marginof the Achilles tendon and posterior skin surface of the ankle was detected in 11 patients(73%). The posteriorskin surface of the ankle had a nodular surface margin in 13 patients(87%). CONCLUSION: A deformed Kager'striangle and Achilles tendon, and an abnormal ill defined radiolucent shadow through the Achilles tendon in alateral view of the ankles are important findings for the diagnesis of in diagnosing achilles tendon rupture.
Achilles Tendon* ; Ankle ; Ankle Injuries ; Humans ; Retrospective Studies ; Rupture* ; Skin ; Tendons