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Related Experiment Videos

Fundal varices: problem and management.

M Abdel-Wahab1, G el-Ebidy, N Gad el-Hak

  • 1Gastroenterology Surgical Center, Mansoura University, Egypt.

Hepato-Gastroenterology
|June 17, 1999
PubMed
Summary

Gastric varices, a cause of upper gastrointestinal bleeding, may develop after injection sclerotherapy. Distal splenorenal shunt (DSRS) is the preferred treatment for fundal varices, showing lower mortality and rebleeding rates.

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Area of Science:

  • Gastroenterology
  • Hepatology
  • Surgical Gastroenterology

Background:

  • Gastric varices are a significant cause of upper gastrointestinal bleeding.
  • The pathophysiology involves generalized or segmental portal hypertension.
  • The role of injection sclerotherapy in gastric variceal development is debated.

Purpose of the Study:

  • To investigate the causes and outcomes of gastric varices.
  • To evaluate different treatment modalities for bleeding gastric varices.
  • To determine the optimal management strategy for fundal varices.

Main Methods:

  • Retrospective analysis of 225 patients with bleeding gastric varices (1987-1997).
  • Classification of varices into primary and secondary fundal varices.

Related Experiment Videos

  • Comparison of outcomes for splenectomy and gastroesophageal decongestion (SGED), distal splenorenal shunt (DSRS), and sclerotherapy.

    • Main Results:

    • Gastric varices were diagnosed in 13.3% of patients with bleeding varices.
    • Pathological diagnoses included schistosomal, non-schistosomal, and mixed etiologies.
    • Distal splenorenal shunt (DSRS) demonstrated the lowest mortality (7.8%) and rebleeding rates (3%) compared to SGED and sclerotherapy.

    Conclusions:

    • Gastric varices are a notable cause of upper gastrointestinal bleeding.
    • Findings suggest gastric varices may be a late complication of injection sclerotherapy.
    • Distal splenorenal shunt (DSRS) is identified as the treatment of choice for managing fundal varices.