Sonography was performed in two patients with acute epigastric pain. Isolated thickening of the duodenal wall with an echogenic line within were considered to be signs of duodenal ulcer in keeping with a suggestive clinical background. The extension of this line beyond the duodenal wall and the periduodenal fluid were indicators of perforation. The images in our two patients indicate the usefulness of ultrasonography when performed carefully in selected cases.