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Detection of rectal and pararectal varices in patients with portal hypertension: efficacy of transvaginal sonography.

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.