Tags

Type your tag names separated by a space and hit enter

Correlation between endoscopic and angiographic findings in patients with esophageal and isolated gastric varices.
Dig Surg. 2001; 18(3):176-81.DS

Abstract

BACKGROUND/AIM

The correlation between angiographic vascular patterns and endoscopic findings in portal hypertension is not sufficiently known, and knowledge of the vascular anatomy may contribute to an improvement in endoscopic embolization and transjugular retrograde obliteration procedures. We propose a new vascular map that should prove useful for this purpose.

METHODS

Between April 1985 and December 1997 we performed percutaneous transhepatic portography in a selected group of 75 patients (16 women and 59 men), aged 43-71 years, from whom informed consent was obtained. All patients had been diagnosed endoscopically as having either esophageal or isolated gastric varices. According to the Child-Pugh classification, class A, B, and C cirrhosis was seen in 19, 40, and 16 patients, respectively. We created a vascular map of esophageal and isolated gastric varices, based on the opacification of the portal venous collaterals on percutaneous transhepatic portography. We compared the patients in both variceal groups in terms of portal venous pressure, main blood supply, and drainage routes.

RESULTS

We found that the portal collateral system was divided into two systems: the portoazygos venous system and the portophrenic venous system. The former contributed to the formation of esophageal and cardiac varices and the latter to the formation of isolated gastric varices located at the fundus or at both the cardia and fundus. The left gastric vein participated as blood supply in 70% of the isolated gastric varices and in 100% of the esophageal varices (p < 0.01). The posterior gastric vein participated as blood supply in 70% of the isolated gastric varices and in 24% of the esophageal varices (p < 0.01). We classified the main blood drainage routes of isolated gastric varices functionally into three types: gastrorenal shunt (85%), gastrophrenic shunt (10%), and gastropericardiac shunt (5%). The portal venous pressure in patients with esophageal varices was 358 +/- 66 mm H(2)O, whereas in patients with isolated gastric varices it was 262 +/- 44 mm H(2)O (p < 0.01).

CONCLUSION

We suggest that this new vascular map will be useful in endoscopic embolization and transjugular retrograde obliteration procedures for esophageal and isolated gastric varices.

Authors+Show Affiliations

Department of Surgery, Kuniyoshi Hospital, Kochi, Japan. chikamori@i-kochi.or.jpNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

11464006

Citation

Chikamori, F, et al. "Correlation Between Endoscopic and Angiographic Findings in Patients With Esophageal and Isolated Gastric Varices." Digestive Surgery, vol. 18, no. 3, 2001, pp. 176-81.
Chikamori F, Kuniyoshi N, Shibuya S, et al. Correlation between endoscopic and angiographic findings in patients with esophageal and isolated gastric varices. Dig Surg. 2001;18(3):176-81.
Chikamori, F., Kuniyoshi, N., Shibuya, S., & Takase, Y. (2001). Correlation between endoscopic and angiographic findings in patients with esophageal and isolated gastric varices. Digestive Surgery, 18(3), 176-81.
Chikamori F, et al. Correlation Between Endoscopic and Angiographic Findings in Patients With Esophageal and Isolated Gastric Varices. Dig Surg. 2001;18(3):176-81. PubMed PMID: 11464006.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Correlation between endoscopic and angiographic findings in patients with esophageal and isolated gastric varices. AU - Chikamori,F, AU - Kuniyoshi,N, AU - Shibuya,S, AU - Takase,Y, PY - 2001/7/21/pubmed PY - 2001/9/14/medline PY - 2001/7/21/entrez SP - 176 EP - 81 JF - Digestive surgery JO - Dig Surg VL - 18 IS - 3 N2 - BACKGROUND/AIM: The correlation between angiographic vascular patterns and endoscopic findings in portal hypertension is not sufficiently known, and knowledge of the vascular anatomy may contribute to an improvement in endoscopic embolization and transjugular retrograde obliteration procedures. We propose a new vascular map that should prove useful for this purpose. METHODS: Between April 1985 and December 1997 we performed percutaneous transhepatic portography in a selected group of 75 patients (16 women and 59 men), aged 43-71 years, from whom informed consent was obtained. All patients had been diagnosed endoscopically as having either esophageal or isolated gastric varices. According to the Child-Pugh classification, class A, B, and C cirrhosis was seen in 19, 40, and 16 patients, respectively. We created a vascular map of esophageal and isolated gastric varices, based on the opacification of the portal venous collaterals on percutaneous transhepatic portography. We compared the patients in both variceal groups in terms of portal venous pressure, main blood supply, and drainage routes. RESULTS: We found that the portal collateral system was divided into two systems: the portoazygos venous system and the portophrenic venous system. The former contributed to the formation of esophageal and cardiac varices and the latter to the formation of isolated gastric varices located at the fundus or at both the cardia and fundus. The left gastric vein participated as blood supply in 70% of the isolated gastric varices and in 100% of the esophageal varices (p < 0.01). The posterior gastric vein participated as blood supply in 70% of the isolated gastric varices and in 24% of the esophageal varices (p < 0.01). We classified the main blood drainage routes of isolated gastric varices functionally into three types: gastrorenal shunt (85%), gastrophrenic shunt (10%), and gastropericardiac shunt (5%). The portal venous pressure in patients with esophageal varices was 358 +/- 66 mm H(2)O, whereas in patients with isolated gastric varices it was 262 +/- 44 mm H(2)O (p < 0.01). CONCLUSION: We suggest that this new vascular map will be useful in endoscopic embolization and transjugular retrograde obliteration procedures for esophageal and isolated gastric varices. SN - 0253-4886 UR - https://www.unboundmedicine.com/medline/citation/11464006/Correlation_between_endoscopic_and_angiographic_findings_in_patients_with_esophageal_and_isolated_gastric_varices_ L2 - https://www.karger.com?DOI=10.1159/000050126 DB - PRIME DP - Unbound Medicine ER -