Incidence and fate of antral varices.
OBJECTIVE
To study the incidence of antral varices (AV) and their fate in patients with portal hypertension so as to formulate a management policy.


METHODS
Prospective cohort study.


METHODS
Single surgical unit specializing in portal hypertension management in a tertiary level centre.


METHODS
Three hundred and seventy-one patients [cirrhosis 170, non-cirrhotic portal fibrosis (NCPF) 53, extrahepatic portal venous obstruction (EHPVO) 148] with history of bleeding from oesophageal varices were inducted in the chronic sclerotherapy programme.


METHODS
Protocol-based endoscopic sclerotherapy and management of bleeding for oesophageal varices.


METHODS
Development or disappearance of AV, bleeding from AV.


RESULTS
No patient had AV on index endoscopy. Thirteen (3.5%) patients developed AV, in cirrhosis 2.9%, EHPVO 4.1%, NCPF 3.8% (P = 0.86). AV developed after a mean of 15 months. Oesophageal varices took a longer number of sessions to obliterate in patients with AV (11.1 vs 5.98 sessions, P<0.0001). Only one patient bled, having coexistent oesophageal varices and gastropathy. AV disappeared spontaneously in seven patients, recurring in only one. Of seven persisting AV, none have bled over a mean follow-up of 30 months (SD 23.2).


CONCLUSIONS
AV are seen in a small proportion of patients, and are distributed equally amongst the aetiologies of portal hypertension. They rarely bleed and may be ignored during sclerotherapy of oesophageal varices.
Shah
S R
SR
Gastroenterology Surgical Services, King Edward VII Memorial Hospital, Bombay, India. shahsudeep@hotmail.com
Desai
C S
CS
Mathur
S K
SK
D015331:Cohort Studies; D004724:Endoscopy; D016099:Endoscopy, Gastrointestinal; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications; D015994:Incidence; D011446:Prospective Studies; D015911:Sclerotherapy