Vnitr Lek 2008, 54(6):597-603

Comparative study of detection and evaluation of the size of oesophageal varices with the use of 12 and 20 MHz frequency radial endosonography vs. esophagogastroduodenoscopy

I. Tozzi^1,*, V. Procházka¹, M. Holinka¹, J. Zapletalová², I. Vinklerová¹

¹ II. interní klinika Lékařské fakulty UP a FN Olomouc, přednosta doc. MUDr. Vlastimil Procházka, Ph.D.

² Ústav lékařské biofyziky Lékařské fakulty UP Olomouc, přednosta prof. Ing. Jan Hálek, CSc.

Introduction:
Portal hypertension is an important marker in the development of life-threatening complications of hepatic cirrhosis. It is the direct cause of oesophageal varices (OV), liver encephalopathy, and of ascites. One of the most important locations where the junctions between the portal and systemic circulation become dilated is the region of the oesophagus and the stomach. Bleeding from OV can be the cause of death in as many as 1/3 of cirrhosis patients with portal hypertension. Oesophagogastroduodenoscopy (EGD) is a standard procedure to examine gastro-oesophageal varices, but radial endosonography (EUS) allows for precise quantification of the size of oesophageal and stomach varices including their diagnosis at a stage when they still cannot be distinguished by standard EGD.


The objective of the study was to assess the benefit of 12 and 20 MHz EUS and EGD in the detection of oesophageal and stomach varices (including varices which still cannot be diagnosed endoscopically) and in determining their size. Another objective was to find out whether there is a link between hepatic functional impairment measured by the Child-Pugh scale and the size of oesophageal varices. We also assessed the incidence and size of varices with respect to portal blood flow measured by Doppler examination.

Method:
The group contained 31 patients with proven hepatic cirrhosis.

Results:
The sensitivity rate of EGD with respect to EUS expressing the portion of patients with a positive outcome was 92%. The specificity rate expressing the quantity of healthy individuals with a negative result was 83%.

Keywords: endosonography; oesophagogastroduodenoscopy; oesophageal varices; gastric varices; hepatic cirrhosis; portal hypertension

Received: January 10, 2008; Accepted: March 7, 2008; Published: June 1, 2008  Show citation