Pitfalls in the reporting of upper endoscopy features in cirrhotic patients

Dig Liver Dis. 2019 Mar;51(3):382-385. doi: 10.1016/j.dld.2018.08.014. Epub 2018 Aug 18.

Abstract

Background: Upper endoscopy is the main tool for the accurate assessment of the risk of bleeding in cirrhotic patients.

Aim: To evaluate the diagnostic accuracy of upper endoscopy, in cirrhotic subjects, during common clinical practice.

Methods: 120 endoscopic reports produced in different hospitals in our region were retrospectively and randomly selected. After a general evaluation, aimed at assessing the description of various endoscopic features, reports were evaluated by four expert endoscopists and four expert hepatologists. Experts were asked to fill in a questionnaire for each single endoscopic procedure, regarding the diagnostic accuracy of the report.

Results: Endoscopic reports lacked descriptions of the size of esophageal varices and red signs in 14% and 29% of cases respectively. Presence (or absence) of gastric varices or portal hypertensive gastropathy were not reported in 62% and 34% of cases respectively. According to expert endoscopists 41% of the reports were incomplete, while, according to hepatologists, reports were incomplete and inadequate for clinical purposes in 36% of cases.

Conclusion: Our study clearly evidenced a significant lack of information in reports on upper endoscopy in cirrhotic patients, and supports the prompt adoption of corrective strategies.

Keywords: Esophageal varices; Hepatology; Portal hypertension; Survey.

MeSH terms

  • Data Accuracy
  • Endoscopy, Gastrointestinal*
  • Esophageal and Gastric Varices / diagnosis
  • Gastrointestinal Hemorrhage / diagnosis*
  • Humans
  • Hypertension, Portal / diagnosis*
  • Liver Cirrhosis / complications*
  • Retrospective Studies
  • Stomach Diseases / diagnosis