Detection of Risky Esophageal Varices by Two-Dimensional Ultrasound: When to Perform Endoscopy
| Autor: | Mohammad Ali, Abd Elrazek, Abd El razek, Mohammad Ali, Hamdy, Mahfouz, Mohamed, Afifi, Mohamed, Nafady, Abd El wahhab, Fathy, Khaled Abd, El azeem, Khaled, Amer, Ahmed, El-shamy, Uryuhara, Kenji, A Ammar, Ghibah, Ammar, Ghiba, Shymaa, Bilasy, Nadia, El-ansary, Mohamed, Fakhry, Magdy, Mansour |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Liver Cirrhosis Male medicine.medical_specialty Cirrhosis Adolescent Esophageal and Gastric Varices Gastroenterology Endoscopy Gastrointestinal Young Adult Esophageal varices Risk Factors Internal medicine Hypertension Portal medicine Humans Mass Screening Prospective Studies Esophagus Prospective cohort study Ultrasonography medicine.diagnostic_test business.industry Incidence Ultrasound General Medicine Middle Aged medicine.disease Endoscopy medicine.anatomical_structure Portal hypertension Female Radiology Varices business |
| Zdroj: | The American Journal of the Medical Sciences. 347:28-33 |
| ISSN: | 0002-9629 |
| DOI: | 10.1097/maj.0b013e3182750ce8 |
| Popis: | Objective Esophageal varices are a consequence of portal hypertension in cirrhotic patients. Current guidelines recommend that all cirrhotic patients undergo screening endoscopy at diagnosis to identify patients with varices at high risk of bleeding who will benefit from primary prophylaxis. This practice increases costs, involves a degree of invasiveness and discomfort and places a heavy burden on endoscopy units. several studies have evaluated possible noninvasive predictors of esophageal varices, but most of these studies remain controversial. Methods The intra-abdominal portion of the esophagus in 673 patients who presented with liver cirrhosis and portal hypertension was examined using standard 2-dimensional (2D) ultrasound. A direct relationship between the degree of varices observed on upper endoscopy and the intra-abdominal esophageal wall thickness was detected using 2D ultrasound. Results The mean thicknesses of the esophageal wall were 3.7 ± 0.5 mm (mean ± standard deviation) in normal individuals, 7.3 ± 3.3 mm in those with esophageal varices and 8.65 ± 1.98 mm in those with risky esophageal varices. The overall accuracy of 2D ultrasound was 95%. Conclusions The intra-abdominal esophagus should be observed during abdominal ultrasound examination in patients with liver cirrhosis. Two-dimensional ultrasound can play an important role in screening for esophageal varices. |
| Databáze: | OpenAIRE |
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