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Duodenal and antral varices

X-ray Department, University Hospital, Mona, Kingston 7, Jamaica

Oesophageal and gastric fundal varices can be demonstrated by barium examination in over 50 per cent of cases with portal hypertension. It is not generally recognised that varices may occur also in the duodenal bulb, pyloric antrum and in other parts of the alimentary tract.

The author reports 18 cases of portal hypertension shown to have oesophageal varices who had lobulated filling defects of the duodenal bulb. In some, linear filling defects of the pyloric antrum were also found. In three, these defects were shown by spleno-portography to be caused by dilated portal venous radicles and evidence is presented to suggest a similar cause in the remaining cases. Varices in this situation are due to anastomoses between branches of the superior mesenteric vein and retro-peritoneal veins.

The differential diagnosis and significance of duodenal and antral varices is discussed.

Received for publication January 1, 1969.