Endoscopic approach to patients with portal hypertension: a complex diagnosis. A retrospective study based on 10 years' experience.
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.
Buccino
R V
RV
III Cattedra Patologia Speciale Chirurgica, Università degli Studi di Roma La Sapienza, Italy.
Bogliolo
G
G
Ferrara
M
M
Pietropaolo
V
V
Pecchioli
L
L
Miscusi
G
G
Montori
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004381:Duodenal Ulcer / Q000150:complications; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D005336:Fiber Optic Technology / Q000379:methods; D005756:Gastritis / Q000150:complications; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013276:Stomach Ulcer / Q000150:complications