Radial endosonography vs. oesophagogastroduodenoscopy in detecting oesophageal and gastric varices

Czech version

Authors: I. Tozzi Di Angelo ¹; V. Procházka ¹; M. Holinka ¹; I. Novotný ²; R. Brůha ³; M. Dvořák ³; I. Vinklerová ¹; J. Zapletalová ⁴; J. Kysučan ⁵
Authors‘ workplace: II. interní klinika, FN Olomouc ¹; Interní hepato-gastroenterologická klinika, FN Brno ²; IV. interní klinika, VFN v Praze ³; Ústav lékařské biofyziky, UP Olomouc ⁴; I. chirurgická klinika, FN Olomouc ⁵
Published in: Gastroent Hepatol 2011; 65(3): 133-140
Category: Hepatology: Original Article

Overview

The aims of the multicentric study were:
1. to assess the sensitivity of 12 and 20 MHz radial endosonography (rEUS) and oesophagogastroduodenoscopy (EGD) in the detection and size of gastric varices (GV) and oesophageal varices (OV); 2. to ascertain the relationship between liver function damage and variceal size; 3. to compare signs of portal hypertension provable in abdominal ultrasonography with endoscopic findings; 4. to evaluate the incidence and size of varices depending on blood flow through the portal vein by Doppler ultrasound. The procedures (endosonography, oesophago-gastroduodenoscopy, transabdominal ultrasonography and Doppler measurement in the portal and lienal veins, determination of liver function reserve) were done, on a blinded basis, by separate teams who were not informed about the results of individual investigations. The group comprised 61 patients suffering from liver cirrhosis with an average age of 54.5±10.5 (23–84). The sensitivity and specificity of rEUS related to EGD in the detection of OV was 94.4% and 71.4%, respectively. The concordance of EGD and rEUS in the detection of oesophageal and gastric varices was 91.8% and 60.6% of cases, respectively, in the localization of OV in 57.1% of cases and in the size of varices in 66%. A statistically significant relationship between the severity of liver disease according to the Child-Pugh classification and the size of OV determined by EGD and rEUS was identified (p=0.012 and p=0.006, respectively). Radial endosonography is capable of a precise diagnosis of the presence of oesophageal and gastric varices. It is a more reproducible method for measuring the size of varices.

Key words:
endosonography – gastrointestinal bleeding – gastroscopy – Child-Pugh classification – liver cirrhosis – esophageal and gastric varices – portal vein

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