Assessment of portal hypertension by endoscopic ultrasonography

Caletti, Giancarlo; Brocchi, Emilio; Baraldini, M.; Ferrari, Alice; Gibilaro, Maria; Barbara, L

doi:10.1016/s0016-5107(90)71011-5

Cited by 133 publications

(77 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[7][8][9] Endoscopic ultrasound is also more sensitive than gastroscopy to distinguish GV from enlarged gastric folds. 10,11 Boustière et al reported a more than 6-fold increase in the rate of GV detection by using EUS compared with gastroscopy. 8 Using EUS as the gold standard, the sensitivity, specificity, positive-predictive value (PPV), and negative-predictive value (NPV) of endoscopy for the diagnosis of GV were 44%, 94%, 78%, and 79%, respectively.…”

Section: Endoscopic Ultrasound Depiction Of Gastric Varicesmentioning

confidence: 99%

Endoscopic Ultrasound (EUS) for Esophageal and Gastric Varices: How Can it Improve the Outcomes and Reduce Complications of Glue Injection

Bhatia

2012

Journal of Clinical and Experimental Hepatology

View full text Add to dashboard Cite

Gastric varices (GV) have three major inflow tracts: (1) left gastric or coronary vein, (2) short gastric veins, and (3) posterior gastric veins. Most GV are formed by the left gastric or posterior gastric vein. 1,2The left gastric or coronary vein decompresses the portal vein directly via hepatofugal blood flow. Gastric varices of the left gastric vein are frequently located at the cardia and sometime extend cephalad to coalesce with the (para)esophageal varices.3 Hashizume et al showed that the anterior branch of the left gastric vein forms the gastroesophageal varices by directly communicating with the submucosal veins, while the posterior branch extends along the outside of the esophageal wall across the esophagogastric junction to drain into the para-esophageal collateral channels. 4 The other major inflow route is via the short gastric veins, which decompress the splenic vein at the splenic hilum ( Figure 1). Gastric varices of the posterior gastric and short gastric veins are frequently located at the fundus and drain into a major porto-systemic shunt. Iwase et al showed that the feeding vein for the junctional type of GV was mainly the left gastric vein, whereas the fundal type of GV was fed by short gastric veins.5 Varices of the gastroepiploic vein are rare but often occur after the treatment of other GV with surgery or coil embolization.The efferent tract of the GV can be upwards into the azygos system, or into one of the major porto-systemic shunt. The majority of varices located at the gastric fundus drain into the inferior phrenic vein, which later joins with the left renal vein to form the gastrorenal shunt (80-85% of cases) or with the inferior vena cava just below A large part of portal venous system and the paragastric and para-esophageal collateral circulation is within the reach of endoscopic ultrasound (EUS). The EUS is more sensitive than gastroscopy for the detection of gastric varices (GV), and can accurately distinguish GV from thickened gastric folds. Gastric varices are depicted by serpiginous, anechoic, Doppler-positive mural channels, with larger collateral channels visible outside the gastric wall. The EUS has also been used to monitor the completeness of GV obturation after glue injection. There are limited data that this strategy may be clinically beneficial to prevent GV re-bleed. The EUS has been used to deliver glue injections under real-time monitoring into the vascular channels, with or without steel coils as scaffolding for the glue. The potential advantages of this technique include a straight scope position, lack of hindrance from pooled blood in gastric fundus, smaller glue volume requirements, and precise intra-vascular placement of glue with avoidance of intramural injections, and reduced embolic complications. (J CLIN EXP HEPATOL 2012;2:70-74) Figure 1 Serpiginous anechoic elongated vascular channels along the upper splenic pole at the gastroesophageal junction and gastric fundus (arrow), suggestive of short gastric vein collaterals (arrowheads).

show abstract

Section: Endoscopic Ultrasound Depiction Of Gastric Varicesmentioning

confidence: 99%

Endoscopic Ultrasound (EUS) for Esophageal and Gastric Varices: How Can it Improve the Outcomes and Reduce Complications of Glue Injection

Bhatia

2012

Journal of Clinical and Experimental Hepatology

View full text Add to dashboard Cite

show abstract

“…21,22 ECDUS is better able to more minutely observe the hemodynamics of esophageal varices than conventional EUS. The direction of blood flow and the measurement of velocity can be diagnosed only via ECDUS.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of arterial blood flow in esophageal varices via endoscopic color Doppler ultrasonography with a galactose-based contrast agent

et al. 2005

View full text Add to dashboard Cite

show abstract

“…Moreover, esophageal and gastric varices, periesophageal and perigastric collateral veins, and submucosal gastric venules are nicely seen [83,84]. However, endoscopy remains the most important technique for the assessment of esophageal varices, as it is superior to EUS in the detection of varices and grading of these vessels according to diameter and length.…”

Section: Eus Rate Dmentioning

confidence: 99%

Endoscopic Ultrasonography

Caletti¹,

Fusaroli²,

Buracco³

1998

Digestion

Self Cite

View full text Add to dashboard Cite

Endoscopic ultrasonography (EUS) is nowadays a clinically relevant technology and its findings can have a major impact on patient management. This technique is currently indicated for staging digestive cancers, assessment of submucosal tumors, diagnosis of intestinal wall infiltrative diseases, common bile-duct stones and gut neuroendocrine tumors. As far as neoplasms are concerned, EUS appears to be a reliable and safe technique, thus making the physician able to plan either an aggressive surgical treatment, or a conservative palliative therapy. This is of the utmost importance in order to optimize medical-related costs, and to make the best therapeutic decision for each individual patient. EUS is also helpful in monitoring the course of a disease, as it is simple and virtually without complications. When EUS findings are not sufficient for a complete diagnosis, it is now possible to perform an EUS-guided fine-needle biopsy, which can allow a cytological diagnosis. Finally, some therapeutic endosonography-guided procedures are being increasingly adopted, such as cystoenterostomy, celiac plexus neurolysis, cholangio-pancreatography and selective injection of botulinum toxin in the muscle layer of the lower esophageal sphincter.

show abstract

Assessment of portal hypertension by endoscopic ultrasonography

Cited by 133 publications

References 16 publications

Endoscopic Ultrasound (EUS) for Esophageal and Gastric Varices: How Can it Improve the Outcomes and Reduce Complications of Glue Injection

Endoscopic Ultrasound (EUS) for Esophageal and Gastric Varices: How Can it Improve the Outcomes and Reduce Complications of Glue Injection

Evaluation of arterial blood flow in esophageal varices via endoscopic color Doppler ultrasonography with a galactose-based contrast agent

Endoscopic Ultrasonography

Contact Info

Product

Resources

About