Echogenic focus in the gastrointestinal wall as a sign of ulceration

An ultrasound study carried out on 22 patients with ulcerated gastrointestinal lesions (20 adenocarcinomas and 2 peptic ulcers) showed, in all cases, an echogenic focus (EF) that was situated in the gastrointestinal wall. In order to find out the histopathologic significance of this focus and its location, an examination was made "in vitro" of 8 surgical specimens obtained from gastrectomies--6 from peptic and 2 from malignant ulcers. The specimens were immersed in a water bath using a 5-MHz transducer. A common finding in all the specimens was an EF similar to that seen in the clinical study and situated behind the crater of the ulcer. In this location the histopathologic findings demonstrated necrotic and inflammatory material in both the benign and malignant lesions.