The ellipse sign--an aid in the diagnosis of acute ulcers

When a persistent collection of barium is seen during a radiographic examination of the upper gastrointestinal tract, differentiation of acute ulceration from non-ulcerating entities (e.g. diverticulum, pseudodiverticulum, residual deformity of surgical intervention) is sometimes difficult. When, however, the persistent collection of barium has an ellipitical configuration, the orientation of the long axis of the ellipse can be an indicator of the nature of the pathologic process. If the long axis is perpendicular to the lumen, the collection represents a deformity without acute ulceration. If the long axis is parallel to the lumen, the collection represents an acute ulceration.