4532 Clinical application of endoscopic ultrasound in portal hypertension: eus can predict variceal recurrence in endoscopically treated patients
| Autor: | Mario Rizzetto, Alessandro Repici, Patrizia Carucci, Valeria Maglione, C. Barletti, Claudio De Angelis, Maurizio Fadda, Giorgio Maria Saracco, Wilma Debernardi Venon, L. Todros |
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| Rok vydání: | 2000 |
| Předmět: |
Endoscopic ultrasound
medicine.medical_specialty medicine.diagnostic_test business.industry medicine.medical_treatment Gastroenterology macromolecular substances medicine.disease Gastroesophageal varices Endoscopy medicine Sclerotherapy Portal hypertension Radiology Nuclear Medicine and imaging In patient Radiology Ligation Varices business |
| Zdroj: | Gastrointestinal Endoscopy. 51:AB160 |
| ISSN: | 0016-5107 |
| Popis: | BACKGROUND AND AIM: 210 After endoscopic eradication of oesophageal varices by means of sclerotherapy or rubber-band ligation, varices recurrence remains a maior problem. Some studies suggested that in patients with endoscopic signs of varices obliteration, EUS may demostrate still patent residual lumina in the esophageal wall. The aim of our study was to assess if EUS can supply usefull information in the evaluation of endoscopic varices eradication in order to predict variceal recurrence and rebleeding.MATERIAL AND METHODS: 107 patients (74 men, mean age 56±11 years) bleeding from gastroesophageal varices underwent endoscopic treatment by means of sclerotherapy or rubber-band ligation until obtaining endoscopic eradication of oesophageal varices in 104 of them. Then they underwent EUS with a rotating sector scanner (Olympus GF-UM3/UMQ130) within 1 month from the treatment. Eighty-six of the 104 eradicated patients had an endoscopic follow-up (8.8 ± 7.1 months) to evaluate the recurrence of oesophageal varices. RESULTS: 56 of the endoscopically eradicated patients (65%) were not judged completely eradicated by EUS, because it made possible to identify still patent variceal lumina or just partially thrombosed vessels or some small residual anechoic structures in the oesophageal wall. Forty-one of them (73%) developed recurrence of oesophageal varices, while just 8 out of the remaining 30 patients (27%), judged eradicated by both endoscopy and EUS, showed oesophageal varices in the follow-up (Chi-square P=0.02). CONCLUSIONS: EUS detects more patent residual vessels in the esophageal wall than endoscopy after endoscopic variceal eradication by means of sclerotherapy or rubber-band ligation. These EUS findings may have a precise clinical impact: predicting variceal recurrence they can indicate the need of further endoscopic therapy. |
| Databáze: | OpenAIRE |
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