[Hemodynamics and treatment based on endoscopic classification of esophago-gastric varices]. 1993

Z Shirai
First Department of Surgery, School of Medicine, Fukuoka University, Japan.

The relationship between endoscopic findings and hemodynamics was studied in 262 patients. The endoscopic findings were classified into 3 groups; 1) Type 1: case with esophageal varices. 2) Type 2: case with esophago-cardiac varices. 3) Type 3: case with fundic varices. The hemodynamics were examined using late phase venography after conventional abdominal angiography. The blood vessels of type 1 resembled those of type 2, and 72% of the cardiac varices were connected with esophageal varices. On the other hand, the blood vessels of type 3 were completely different from those of type 1 and type 2, and 84% of the fundic varices were connected with large gastro-renal shunts. From these results, I have been applying endoscopic in injection sclerotherapy for types 1 and 2, and Hassab's operation for type 3. The rates of hemostasis were 100%, 93% and 100% in types 1, 2 and 3, respectively. The rates of disappearance of the varices after treatment were 78.7%, 87% and 100% in types 1, 2 and 3, respectively. It is concluded that good therapeutic results can be obtained when an appropriate therapeutic method is selected. Treatment should be based on the hemodynamics associated with the endoscopic findings of esophago-gastric varices.

UI MeSH Term Description Entries
D004630 Emergencies Situations or conditions requiring immediate intervention to avoid serious adverse results. Emergency
D004932 Esophageal and Gastric Varices Dilated blood vessels in the ESOPHAGUS or GASTRIC FUNDUS that shunt blood from the portal circulation (PORTAL SYSTEM) to the systemic venous circulation. Often they are observed in individuals with portal hypertension (HYPERTENSION, PORTAL). Esophageal Varices,Gastric Varices,Esophageal Varix,Gastric Varix,Varices, Esophageal,Varices, Gastric,Varix, Esophageal,Varix, Gastric
D004945 Esophagoscopy Endoscopic examination, therapy or surgery of the esophagus. Esophagoscopic Surgical Procedures,Surgical Procedures, Esophagoscopic,Esophagoscopic Surgery,Surgery, Esophagoscopic,Esophagoscopic Surgeries,Esophagoscopic Surgical Procedure,Esophagoscopies,Procedure, Esophagoscopic Surgical,Procedures, Esophagoscopic Surgical,Surgeries, Esophagoscopic,Surgical Procedure, Esophagoscopic
D006439 Hemodynamics The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM. Hemodynamic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D015911 Sclerotherapy Treatment of varicose veins, hemorrhoids, gastric and esophageal varices, and peptic ulcer hemorrhage by injection or infusion of chemical agents which cause localized thrombosis and eventual fibrosis and obliteration of the vessels. Sclerotherapies

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