Gastric Fundic Varices (gastric + fundic_varices)

Distribution by Scientific Domains


Selected Abstracts


GASTRIC FUNDIC VARICES: HEMODYNAMICS AND NON-SURGICAL TREATMENT

DIGESTIVE ENDOSCOPY, Issue 3 2005
Seishu Hayashi
The hemodynamics and non-surgical treatment of gastric fundic varices (FV) are reviewed. FV are more frequently supplied by the short and posterior gastric veins than esophageal varices (EV), and are formed mostly by large spontaneous shunts in which the gastric or splenic vein is continuous with the left renal vein via the inferior phrenic veins and the suprarenal vein (so-called gastric-renal shunt). Concomitant collaterals such as EV, para-esophageal vein, and para-umbilical vein were also observed in nearly 60% of FV. Endoscopic injection sclerotherapy (EIS) with Histoacryl is thought to be the most approved treatment for hemorrhage from FV, but repeated treatment for residual FV and care for ensuing hepatic failure are required. Balloon-occluded retrograde transvenous obliteration (B-RTO) is a notable interventional radiological procedure specially developed for the elective or prophylactic treatment of FV. If the procedure is technically successful, long-term eradication of treated FV is found in most patients without recurrence. B-RTO includes another significance, obliteration of the unified portal-systemic shunt. Follow-up abdominal CT scan revealed a high incidence of long-term obliteration of the gastric-renal shunt after B-RTO. Benefits such as elevation of serum albumin, improvement in 15-min retention rate of indocyanine green, decrease in blood ammonia levels, and improvement of encephalopathy are sometimes observed. [source]


Preliminary assessment of miniprobe sonography in the diagnosis of gastric varices and evaluation of treatment with Histoacryl

JOURNAL OF DIGESTIVE DISEASES, Issue 1 2001
Zhu Qi
OBJECTIVE: In comparison with conventional endoscopy, the clinical value of miniprobe sonography (MPS) was assessed both in the diagnosis of gastric varices (GV) and in the evaluation of its treatment with the tissue adhesive agent Histoacryl. METHODS: Twelve patients with liver cirrhosis and portal hypertension caused by hepatitis B in nine cases and hepatitis C in three cases were examined by MPS to verify the presence of gastric fundic varices before and after endoscopic treatment with Histoacryl. Curative efficacy of Histoacryl treatment was defined by the finding of variceal lumen obliteration characteristics in the ultrasonic image. RESULTS: Gastric fundic varices were detected in 10 patients by using MPS, however, only seven cases were detected by using conventional macroscopic examination. For gastric fundic varices, the diagnostic accuracies of standard endoscopy and MPS were 75% (9/12) and 100% (12/12), respectively. Furthermore, MPS was able to produce a practical ultrasonic image of complete or incomplete variceal vessel lumen obliteration for use in the assessment of the efficacy of endoscopic treatment with Histoacryl. CONCLUSIONS: Miniprobe sonography was found to be significantly superior to conventional macroscopic diagnosis in both the detection of fundic varices and the evaluation of the efficacy of endoscopic therapy. Moreover, MPS could play an important role in follow up and in evaluation of the need for further treatment. Therefore, MPS appears to be a safe and very useful clinical technique in evaluating patients with portal hypertension with respect to the detection of fundic varices and may help in selecting patients for appropriate therapy. [source]


GASTRIC FUNDIC VARICES: HEMODYNAMICS AND NON-SURGICAL TREATMENT

DIGESTIVE ENDOSCOPY, Issue 3 2005
Seishu Hayashi
The hemodynamics and non-surgical treatment of gastric fundic varices (FV) are reviewed. FV are more frequently supplied by the short and posterior gastric veins than esophageal varices (EV), and are formed mostly by large spontaneous shunts in which the gastric or splenic vein is continuous with the left renal vein via the inferior phrenic veins and the suprarenal vein (so-called gastric-renal shunt). Concomitant collaterals such as EV, para-esophageal vein, and para-umbilical vein were also observed in nearly 60% of FV. Endoscopic injection sclerotherapy (EIS) with Histoacryl is thought to be the most approved treatment for hemorrhage from FV, but repeated treatment for residual FV and care for ensuing hepatic failure are required. Balloon-occluded retrograde transvenous obliteration (B-RTO) is a notable interventional radiological procedure specially developed for the elective or prophylactic treatment of FV. If the procedure is technically successful, long-term eradication of treated FV is found in most patients without recurrence. B-RTO includes another significance, obliteration of the unified portal-systemic shunt. Follow-up abdominal CT scan revealed a high incidence of long-term obliteration of the gastric-renal shunt after B-RTO. Benefits such as elevation of serum albumin, improvement in 15-min retention rate of indocyanine green, decrease in blood ammonia levels, and improvement of encephalopathy are sometimes observed. [source]


Preliminary assessment of miniprobe sonography in the diagnosis of gastric varices and evaluation of treatment with Histoacryl

JOURNAL OF DIGESTIVE DISEASES, Issue 1 2001
Zhu Qi
OBJECTIVE: In comparison with conventional endoscopy, the clinical value of miniprobe sonography (MPS) was assessed both in the diagnosis of gastric varices (GV) and in the evaluation of its treatment with the tissue adhesive agent Histoacryl. METHODS: Twelve patients with liver cirrhosis and portal hypertension caused by hepatitis B in nine cases and hepatitis C in three cases were examined by MPS to verify the presence of gastric fundic varices before and after endoscopic treatment with Histoacryl. Curative efficacy of Histoacryl treatment was defined by the finding of variceal lumen obliteration characteristics in the ultrasonic image. RESULTS: Gastric fundic varices were detected in 10 patients by using MPS, however, only seven cases were detected by using conventional macroscopic examination. For gastric fundic varices, the diagnostic accuracies of standard endoscopy and MPS were 75% (9/12) and 100% (12/12), respectively. Furthermore, MPS was able to produce a practical ultrasonic image of complete or incomplete variceal vessel lumen obliteration for use in the assessment of the efficacy of endoscopic treatment with Histoacryl. CONCLUSIONS: Miniprobe sonography was found to be significantly superior to conventional macroscopic diagnosis in both the detection of fundic varices and the evaluation of the efficacy of endoscopic therapy. Moreover, MPS could play an important role in follow up and in evaluation of the need for further treatment. Therefore, MPS appears to be a safe and very useful clinical technique in evaluating patients with portal hypertension with respect to the detection of fundic varices and may help in selecting patients for appropriate therapy. [source]