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Perforating Veins in Recurrent Esophageal Varices after Endoscopic Therapy Visualized by Endoscopic Color Doppler Ultrasonography
Author(s) -
SATO Takahiro,
YAMAZAKI Katsu,
TOYOTA Jouji,
KARINO Yoshiyasu,
OHMURA Takumi,
SUGA Toshihiro
Publication year - 1999
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.1999.tb00009.x
Subject(s) - medicine , esophageal varices , varices , esophagus , radiology , varix , color doppler , varicose veins , blood flow , surgery , ultrasonography , portal hypertension , cirrhosis
This study was designed to evaluate the detection rate and the direction of blood flow of perforating veins using endoscopic color Doppler ultrasonography (EC‐DUS) in cases of recurrent esophageal varices after endoscopic therapy with complete eradication. Perforating veins were defined as vessels communicating between esophageal varices and paraesophageal veins. The study involved thirty patients with recurrent esophageal varices who had been followed up for more than one year. Seven of them had high risk intramucosal venous dilatation (IMVD) of the esophagus, and 23 had F 1 (small straight varices) red color (RC) positive varices. Color flow images of perforating veins were obtained in 18 patients (60.0%). The perforating veins were classified into three types according to flow direction. Type 1 had inflow from paraesophageal veins to esophageal varices, Type 2 had outflow type from esophageal varices to paraesophageal veins, and Type 3 was mixed, showing both inflow and outflow. Of the 18 patients in whom color flow images were obtained, 15 (83.3%) cases were Type 1, none were Type 2, and three (16.7%) were Type 3. All the color flow images in the perforating veins were demonstrated as a continuous wave. In conclusion, perforating veins can be detected at a high rate by ECDUS in cases of recurrent esophageal varices after endoscopic therapy with complete eradication. (Dig Endosc 1999; 11: 236–240)