[A retrospective analysis of ectopic varices in gastrointestinal tract diagnosed by endoscopy].
OBJECTIVE
To understand the incidence, causes, clinical manifestations and treatment of ectopic varices (EV) in gastrointestinal (GI) tract.


METHODS
GI endoscopic examinations were carried out in 99 783 patients from January 2004 to October 2012 in General Hospital of PLA. Sixty-four cases of ectopic varices in GI tract were discovered. The clinical manifestations of EV patients and treatment were analyzed retrospectively. The literatures of EV were reviewed.


RESULTS
The prevalence of EV in GI was 0.06% (64/99 783) in all patients undergoing endoscopic examinations, including 5 in the gastric antrum, 37 in the duodenum, 2 in the colon, 17 in the rectum, 1 in terminal ileum as well as whole colorectum, and 2 in the anastomotic stomas. The causes of EV included portal hypertension with cirrhosis in 52 cases (42 of hepatitis as dominant, 5 of alcoholic, 3 of biliary). Twenty-five cases had past history of endoscopic sclerotherapy, tissue adhesive injection or band ligation.Extrahepatic portal vein obstruction was seen in 4 cases (1 with pancreatic cancer, gastric cardia after surgery, pancreatic cancer after surgery, small intestine after partial hepatectomy respectively) and 8 cases uncertain. Nine cases accepted endoscopic tissue adhesive injection (no post-operative hemorrhage occurred in 9 cases and EV disappeared in 3 cases). Endoscopic band ligation was performed only for one patient.


CONCLUSIONS
EV in GI tract is a rare condition, which occurs commonly in duodenum, colon, and rectum. Portal hypertension is the most common cause. Gastrointestinal hemorrhage is the main clinical manifestation. EV should be considered in GI bleeding, with gastroesophageal varices hemorrhage excluded. Endoscopic adhesive injection is an effective way to treat EV.
Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing 100853, China.
Nan
N
Li
Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing 100853, China. Email: liuyingdi301@ sina.com.
Ying-di
YD
Liu
Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing 100853, China.
Yun-sheng
YS
Yang
Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing 100853, China.
En-qiang
EQ
Linghu
Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing 100853, China.
Guo-jun
GJ
Chai
Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing 100853, China.
Guo-hui
GH
Sun
Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing 100853, China.
Yong-ping
YP
Mao
Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing 100853, China.
Hua
H
Jiang
Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing 100853, China.
Juan
J
Wang
Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing 100853, China.
Jing
J
Yang
Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing 100853, China.
Hao
H
Liang
D000293:Adolescent; D000328:Adult; D000368:Aged; D004724:Endoscopy; D005260:Female; D041981:Gastrointestinal Tract / Q000098:blood supply; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014648:Varicose Veins / Q000175:diagnosis*; D055815:Young Adult