Original ArticlesCatheter US probe EUS evaluation of gastric cardia and perigastric vascular structures to predict esophageal variceal recurrence☆
Section snippets
Patients and methods
Thirty consecutive patients (20 men, 10 women; median age 56 years; interquartile range [IQR] 51-64 years) with high-risk esophageal varices were studied between October 1996 and April 2000. Varices in all patients exhibited severe red color signs, which are believed to indicate a high risk for variceal rupture.10 Seven patients had a history of endoscopically proven variceal bleeding that had been treated by balloon tamponade alone. Patients who had undergone emergent endoscopic treatments to
Results
Recurrence of esophageal varices was detected endoscopically in 14 of the 30 patients (46.7%) within 3 months after EVL. There was no statistically significant difference in any of the clinical characteristics between the recurrent and nonrecurrent groups except for age and the proportion of patients with a history of variceal hemorrhage (Table 2).Empty Cell Total (n = 30) Nonrecurrent group (n = 16) Recurrent group (n =
Discussion
Calletti et al.1 were the first to report the usefulness of conventional EUS for evaluation of esophagogastric varices in patients with portal hypertension. These investigators reported that EUS with a 7.5-MHz transducer was superior to conventional endoscopy for detecting varices in the fundus of the stomach, and that there was a direct correlation between the endoscopic grade of the esophageal varices and the diameter of the paraesophageal collaterals on EUS. The 7.5-MHz probe is especially
Acknowledgements
We are grateful to Dr. Hajiro K, MD (Tenri hospital, Nara, Japan) and Dr. Kajiyama T, ND (Kansai Denryoku hospital, Osaka, Japan) for editorial assistance in the preparation of this manuscript.
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2012, Gastrointestinal Endoscopy Clinics of North AmericaCitation Excerpt :Krige and colleagues24 found a correlation between the number of endoscopic sclerotherapy sessions required to achieve eradication and the presence of collaterals. EUS enables the visualization and targeting of perforating veins and collaterals for sclerotherapy.23,25,26 Lahoti and colleagues27 first reported the use of EUS-guided endoscopic sclerotherapy to achieve variceal obliteration.
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Reprint requests: Yasuhiro Konishi, MD, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-Rawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.