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New abdominal collaterals at ultrasound: a clue of progression of portal hypertension.
Dig Liver Dis. 2008 Jan; 40(1):62-7.DL

Abstract

BACKGROUND

Abdominal ultrasound can detect non-invasively the presence of abdominal portal-systemic collaterals in patients with liver cirrhosis. Abdominal portal-systemic collaterals may be protective from the formation and growth of oesophageal varices, but available data are inconclusive.

AIM

We aimed at investigating the relationship between abdominal portal-systemic collaterals and variceal formation and growth.

METHODS

We studied 126 cirrhotic patients without (n=43) or with small (n=83) oesophageal varices who entered a protocol of serial ultrasonographic and endoscopic examinations for a median of 55 months. Presence and kind of abdominal portal-systemic collaterals was recorded on first ultrasonography and on each control thereafter.

RESULTS

At inclusion, abdominal portal-systemic collaterals were found in 19/43 patients without varices and in 23/83 patients with small varices (NS). There was no difference in variceal formation and growth between patients with and without abdominal portal-systemic collaterals at inclusion. However, patients developing new abdominal portal-systemic collaterals during follow-up had a significantly higher rate of variceal formation (56.2% vs. 22.2%; p=0.024) and growth (52.9% vs. 30.6%; p=0.041) compared with patients with unchanged ultrasonography.

CONCLUSIONS

Abdominal collaterals are not protective from the formation or growth of oesophageal varices. Conversely, new abdominal portal-systemic collaterals emergence is a non-invasive clue of formation and progression of varices. Therefore, endoscopy is probably indicated whenever new abdominal portal-systemic collaterals are detected in cirrhotic patients.

Authors+Show Affiliations

Department of Internal Medicine, Cardioangiology, Hepatology, University of Bologna, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17913603

Citation

Berzigotti, A, et al. "New Abdominal Collaterals at Ultrasound: a Clue of Progression of Portal Hypertension." Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, vol. 40, no. 1, 2008, pp. 62-7.
Berzigotti A, Merkel C, Magalotti D, et al. New abdominal collaterals at ultrasound: a clue of progression of portal hypertension. Dig Liver Dis. 2008;40(1):62-7.
Berzigotti, A., Merkel, C., Magalotti, D., Tiani, C., Gaiani, S., Sacerdoti, D., & Zoli, M. (2008). New abdominal collaterals at ultrasound: a clue of progression of portal hypertension. Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 40(1), 62-7.
Berzigotti A, et al. New Abdominal Collaterals at Ultrasound: a Clue of Progression of Portal Hypertension. Dig Liver Dis. 2008;40(1):62-7. PubMed PMID: 17913603.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - New abdominal collaterals at ultrasound: a clue of progression of portal hypertension. AU - Berzigotti,A, AU - Merkel,C, AU - Magalotti,D, AU - Tiani,C, AU - Gaiani,S, AU - Sacerdoti,D, AU - Zoli,M, Y1 - 2007/10/29/ PY - 2007/05/04/received PY - 2007/08/07/revised PY - 2007/08/22/accepted PY - 2007/10/5/pubmed PY - 2008/4/9/medline PY - 2007/10/5/entrez SP - 62 EP - 7 JF - Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver JO - Dig Liver Dis VL - 40 IS - 1 N2 - BACKGROUND: Abdominal ultrasound can detect non-invasively the presence of abdominal portal-systemic collaterals in patients with liver cirrhosis. Abdominal portal-systemic collaterals may be protective from the formation and growth of oesophageal varices, but available data are inconclusive. AIM: We aimed at investigating the relationship between abdominal portal-systemic collaterals and variceal formation and growth. METHODS: We studied 126 cirrhotic patients without (n=43) or with small (n=83) oesophageal varices who entered a protocol of serial ultrasonographic and endoscopic examinations for a median of 55 months. Presence and kind of abdominal portal-systemic collaterals was recorded on first ultrasonography and on each control thereafter. RESULTS: At inclusion, abdominal portal-systemic collaterals were found in 19/43 patients without varices and in 23/83 patients with small varices (NS). There was no difference in variceal formation and growth between patients with and without abdominal portal-systemic collaterals at inclusion. However, patients developing new abdominal portal-systemic collaterals during follow-up had a significantly higher rate of variceal formation (56.2% vs. 22.2%; p=0.024) and growth (52.9% vs. 30.6%; p=0.041) compared with patients with unchanged ultrasonography. CONCLUSIONS: Abdominal collaterals are not protective from the formation or growth of oesophageal varices. Conversely, new abdominal portal-systemic collaterals emergence is a non-invasive clue of formation and progression of varices. Therefore, endoscopy is probably indicated whenever new abdominal portal-systemic collaterals are detected in cirrhotic patients. SN - 1590-8658 UR - https://www.unboundmedicine.com/medline/citation/17913603/New_abdominal_collaterals_at_ultrasound:_a_clue_of_progression_of_portal_hypertension_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1590-8658(07)00524-5 DB - PRIME DP - Unbound Medicine ER -