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Related Experiment Videos

Bleeding esophagogastric varices: an endoscopic study.

M Buset, B Des Marez, M Baize

    The American Journal of Gastroenterology
    |March 1, 1987
    PubMed
    Summary

    Esophageal or gastric varices are often found in patients with upper gastrointestinal bleeding, but are not always the cause. Endoscopic diagnosis of variceal bleeding requires careful evaluation of stigmata.

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    Area of Science:

    • Gastroenterology
    • Hepatology
    • Endoscopy

    Background:

    • Acute upper gastrointestinal hemorrhage is a common clinical emergency.
    • Esophageal and gastric varices are known potential causes of severe bleeding.

    Purpose of the Study:

    • To determine the actual incidence of variceal bleeding as the source of acute upper gastrointestinal hemorrhage.
    • To identify the endoscopic stigmata associated with variceal bleeding.
    • To compare the frequency of variceal bleeding with other causes of hemorrhage.

    Main Methods:

    • Retrospective analysis of 857 patients admitted with acute upper gastrointestinal hemorrhage.
    • Endoscopic evaluation to identify bleeding sources and stigmata.
    • Classification of bleeding lesions, including esophageal/gastric varices, peptic ulcers, and erosive gastritis.

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    Main Results:

    • 19.5% of patients had esophageal or gastric varices; only 9.7% had varices as the confirmed bleeding source.
    • Endoscopic stigmata of variceal bleeding were observed in 92% of cases with confirmed variceal bleeding.
    • Peptic ulcers (38%) and erosive gastritis (36%) were more common bleeding sources than varices.
    • One-third of patients with bleeding varices required multiple endoscopies for diagnosis.
    • Cardia was the most frequent bleeding site; variceal size correlated with bleeding.

    Conclusions:

    • Esophageal and gastric varices are frequently present but not always the cause of acute upper gastrointestinal hemorrhage.
    • Careful endoscopic assessment for specific stigmata is crucial for diagnosing variceal bleeding.
    • Other lesions like peptic ulcers and erosive gastritis are significant contributors to upper GI bleeding.