Is computerised tomography better than fibreoptic gastroscopy for early detection of gastric varices?
BACKGROUND
Video endoscopic diagnosis of gastric varices is particularly limited, owing to the deep submucosal or subserosal location of the varices and the normal appearance of the overlying mucosa.


OBJECTIVE
We present and emphasise the value of computerised tomography (CT) examination in the early detection of gastric varices (GVs).


METHODS
In this retrospective study, a total of 216 consecutive patients with cirrhosis were evaluated at the Turkiye Yuksek Ihtisas Training and Research Hospital between September 2008 and March 2011.


RESULTS
One hundred and thirty patients with cirrhosis were enrolled in the study. The mean age of the male (88 cases) patients was 59.45 ±2.42 years, and the mean age of the female (42 cases) patients was 56.29 ±1.14 years. Computerised tomography identified oesophageal varices (EVs) in 103/130 patients, and endoscopy identified EVs in 103/130 patients. Computerised tomography identified GVs in 86/130 patients, and endoscopy identified GVs in 26/130 patients. After endoscopic elastic band ligation (EBL), CT identified GVs in 22/26 patients, and endoscopy identified GVs in 7/26 patients.


CONCLUSIONS
Gastric varices lie in the submucosa, deeper than EVs, and distinguishing GVs from gastric rugae may be difficult with video endoscopy. This study demonstrated that CT is a sensitive method for early detection of GVs and has been used previously in the evaluation of GVs.
Department of Gastroenterology, Medical Faculty, Yuzuncu Yil University, Van, Turkey.
Burak
B
Suvak
Department of Gastroenterology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.
Murat
M
Kekilli
Department of Gastroenterology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.
Yavuz
Y
Beyazıt
Department of Radiology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.
Sarper
S
Okten
Department of Gastroenterology, GATA Haydarpasa Training Hospital, Istanbul, Turkey.
Alpaslan
A
Tanoglu
Department of Gastroenterology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.
Nurgul
N
Sasmaz
computerised tomography; endoscopy; gastric varices