CT evaluation of esophageal and upper abdominal varices

Recognition of major abdominal visceral vessels is an integral part of the interpretation of upper abdominal computed tomography (CT) studies. Perivisceral portal systemic varices appear as lobulated or discrete rounded tubular densities in characteristic sites, including periesophageal, perigastric, and peripancreatic locations, the pararenal spaces, and the gallbladder fossa. To avoid confusion with lymphadenopathy and soft tissue tumors, the varices can be specifically identified using contrast enhancement techniques and fast scan times. In portal hypertension, contrast enhanced CT can be used to define both the extrahepatic portal system and the location of the perivisceral varices.