USEFULNESS OF ENDOSCOPIC ULTRASONOGRAPHIC ANALYSIS OF VARICEAL HEMODYNAMICS FOR THE TREATMENT OF ESOPHAGEAL VARICES

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概要

• 論文の詳細を見る

• The correlation of between the endoscopic findings of esophageal varices and endoscopic ultrasound findings of the collaterals outside the esophageal wall in patients with portal hypertension remains unclear. We investigated the relationship between esophageal varices and the collaterals by endoscopy and endoscopic ultrasound. Moreover, we investigated the correlation between the collaterals around the esophagus and recurrence of esophageal varices in patients with portal hypertension who had undergone endoscopic injection sclerotherapy. The collaterals were divided into two groups : 1 ; those with peri-esophageal collateral veins (peri-ECVs) adjacent to the muscularis externa of the esophagus, and 2 ; those with para-esophageal collateral veins (para-ECVs) distal to the esophageal wall without contact with the muscularis externa. Peri-and para-ECVs were scored as mild or severe according to the stage of development. According to endoscopy, the varix form was significantly larger in severe peri-ECVs group than in mild peri-ECVs group. In contrast, the varix form did not differ significantly between the mild and severe para-ECVs group. The prevalence of perforating veins increased according to the varix form. With regard to variceal recurrence, in patients with variceal recur-rences, EUS findings included a significantly higher incidence of severe-type peri-ECVs, a significantly larger number of perforating veins, and a significantly larger diameter of perforating veins compared with patients without recurrence. Moreover, when EUS found the abnormalities when no endoscopic recurrence was found, the results were the almost same as the findings when EUS was performed at the same time when endoscopic recurrence was found. In conclusion, the presence of severe peri-ECVs and large perforating veins in the esophageal wall strongly correlates with occurrence and recurrence of esophageal varices in patients with portal hypertension. An understanding of these EUS abnormalities on the basis of hemodynamics around the esophagus is thought to be important for management of esophageal varices in patients with portal hypertension.

• 福島医学会の論文

著者

• Obara Katsutoshi

  Department Of Endoscopy Fukushima Medical University Hospital

• SAITO Ayako

  Department of Internal Medicine II, Fukushima Medical University School of Medicine

• Saito Ayako

  Department Of Cell Physiology Kyorin University School Of Medicine

• Hikichi Takuto

  Department Of Endoscopy Fukushima Medical University Hospital

• Sato Yukio

  Department Of Advanced Materials Science Graduate School Of Frontier Science The University Of Tokyo

• Yamamoto Go

  Department Of Clinical Laboratory Nishi-kobe Medical Center

• Oyama Hitoshi

  Department Of Chemistry And Chemical Engineering Faculty Of Engineering Kanazawa University

• Katakura Kyoko

  Department Of Internal Medicine 2 Fukushima Medical University School Of Medicine

• Shishido Hideo

  Department Of Hematology Meitetsu Hospital

• Takagi Tadayuki

  Department Of Gastroenterology Aichi Cancer Center Hospital

• Sato Naoto

  Department Of Biological Sciences Graduate School Of Science University Of Tokyo

• Sakamoto Hiroaki

  Department Of Biological Functions And Engineering Kyushu Instiute Of Technology

• Kasukawa Reiji

  Department Of Internal Medicine 2 Fukushima Medical University School Of Medicine

• Takiguchi Fujio

  Department Of Internal Medicine 2 Fukushima Medical University School Of Medicine

• Shibukawa Goro

  Department Of Gastroenterology And Rheumatology Fukushima Medical University School Of Medicine

• IRISAWA ATSUSHI

  Department of Gastroenterology and Rheumatology

• IRISAWA ATSUSHI

  Department of Internal Medicine II, Fukushima Medical University School of Medicine

• HIKICHI TAKUTO

  Department of Internal Medicine II, Fukushima Medical University School of Medicine

• SHISHIDO HIDEO

  Department of Internal Medicine II, Fukushima Medical University School of Medicine

• Yamamoto Go

  Department of Clinical Laboratory Medicine, Nishi-Kobe Medical Center, Japan

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