Endoscopic approach to patients with portal hypertension: a complex diagnosis. A retrospective study based on 10 years' experience

Surg Endosc. 1990;4(2):76-9. doi: 10.1007/BF00591262.

Abstract

We analyzed the endoscopic findings in 788 patients with esophageal and gastric varices who underwent upper gastrointestinal endoscopy between 1 January 1979 and 31 December 1988. Of these, 154 patients (19.6%) had gastric varices associated in various patterns with esophageal varices. Congestive gastropathy, occurring with esophageal and gastric varices (43.4%), was the most frequent pathology detected in our patients. Esophagitis was present in 15.8% of patients, but did not correlate with variceal bleeding. Endoscopy performed at 1 day to 1 week post-hemorrhage in 313 patients accurately identified the source of bleeding in only 57.2% of patients. This figure increased to 98.2% when we performed the examination within the first 24 h of hemorrhage. In this group varices were the source of hemorrhage in 72.3% of patients while the hemorrhage came from other sources, such as erosive gastritis, duodenal and gastric ulcer in 27.6% of patients.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Duodenal Ulcer / complications
  • Esophageal and Gastric Varices / complications
  • Esophageal and Gastric Varices / diagnosis*
  • Esophageal and Gastric Varices / epidemiology
  • Esophagoscopy / methods*
  • Female
  • Fiber Optic Technology / methods
  • Gastritis / complications
  • Gastrointestinal Hemorrhage / diagnosis
  • Gastrointestinal Hemorrhage / etiology
  • Gastroscopy / methods*
  • Humans
  • Hypertension, Portal / complications*
  • Incidence
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stomach Ulcer / complications