Endoscopic approach to patients with portal hypertension : a complex diagnosis. A retrospective study based on 10 years' experience

• Published in: Surgical endoscopy Vol. 4; no. 2; pp. 76 - 79
• Main Authors: BUCCINO, R. V, BOGLIOLO, G, FERRARA, M, PIETROPAOLO, V, PECCHIOLI, L, MISCUSI, G, MONTORI, A
• Format: Journal Article
• Language: English
• Published: New York, NY Springer 1990
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Duodenal Ulcer - complications; Esophageal and Gastric Varices - complications; Esophageal and Gastric Varices - diagnosis; Esophageal and Gastric Varices - epidemiology; Esophagoscopy - methods; Esophagus; Female; Fiber Optic Technology - methods; Gastritis - complications; Gastroenterology. Liver. Pancreas. Abdomen; Gastrointestinal Hemorrhage - diagnosis; Gastrointestinal Hemorrhage - etiology; Gastroscopy - methods; Humans; Hypertension, Portal - complications; Incidence; Male; Medical sciences; Middle Aged; Other diseases. Semiology; Retrospective Studies; Stomach Ulcer - complications; Human; Diseases of portal circulation; Portal hypertension; Digestive diseases; Complication; Diagnosis; Endoscopy; Hemorrhage; Esophagus; Varix
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/BF00591262

We analyzed the endoscopic findings in 788 patients with esophageal and gastric varices who underwent upper gastrointestinal endoscopy between 1 January 1979 and 31 December 1988. Of these, 154 patients (19.6%) had gastric varices associated in various patterns with esophageal varices. Congestive gastropathy, occurring with esophageal and gastric varices (43.4%), was the most frequent pathology detected in our patients. Esophagitis was present in 15.8% of patients, but did not correlate with variceal bleeding. Endoscopy performed at 1 day to 1 week post-hemorrhage in 313 patients accurately identified the source of bleeding in only 57.2% of patients. This figure increased to 98.2% when we performed the examination within the first 24 h of hemorrhage. In this group varices were the source of hemorrhage in 72.3% of patients while the hemorrhage came from other sources, such as erosive gastritis, duodenal and gastric ulcer in 27.6% of patients.