Transnasal endoscopy as a complementary tool for ambulatory detection of clinically significant portal hypertension

The efficacy, safety, and tolerability of transnasal endoscopy were evaluated as a complementary tool for detecting endoscopic signs consistent with portal hypertension in adults with compensated advanced chronic liver disease. Twenty-four patients underwent transnasal upper gastrointestinal endoscopy under local anesthesia and noninvasive assessment of liver fibrosis through elastography and platelet count. Procedure-related pain intensity and anxiety, adverse events, and impact on therapeutic decision-making were analyzed. The procedure was well tolerated, with no adverse events, and periprocedural discomfort and anxiety were minimal-to-mild. Transnasal endoscopy modified therapeutic decisions in 37.5% of cases, compared with the exclusive use of noninvasive methods. The findings suggest that transnasal endoscopy may provide additional value for the ambulatory detection of portal hypertension, as it is a rapid and practical procedure.