Skip to main content
SpringerLink
Log in

Valeur diagnostique de l'endoscople digestive haute au cours de la cirrhose

Upper digestive endoscopy in the diagnosis of cirrhosis

  • Published:
Acta Endoscopica

Résumé

But

Le but principal de notre étude était d'évaluer la prévalence des signes endoscopiques de la cirrhose et d'en préciser la performance diagnostique pour celle-ci.

Méthodes

L'étude prospective s'est déroulée de janvier 1997 à février 1999 dans les hôpitaux nationaux du Point «G» et Gabriel Touré de Bamako (Mali). Les critères diagnostiques de la cirrhose étaient l'examen histologique ou l'association d'un gros foie à bord inférieur tranchant, d'un taux de prothrombine bas et d'un aspect échographique ou laparoscopique de cirrhose. Les hépatopathies chroniques sans cirrhose, prises comme témoins ont toutes été histologiquement prouvées.

Résultats

Au terme de l'étude, 116 patients ont été inclus dont 56 cas de cirrhose et 60 hépatopathies non cirrhotiques. Les varices œsophagiennes, la gastropathie d'HTP et les érosions étaient significativement plus fréquentes dans le groupe cirrhose. Huit variables étaient significativement différentes entre les 2 groupes et ont été incluses dans une analyse discriminante: l'antigène HBs, les varices œsophagiennes, les érosions et l'ictére avaient une valeur prédictive indépendante avec une performance diagnostique de 89% pour la cirrhose.

Conclusion

Notre étude, dont l'originalité est un diagnostic de référence reposant sur la laparoscopie, confirme que les signes endoscopiques ont une valeur indépendante dans le diagnostic de cirrhose.

Summary

Aims

The main objective was to evaluate the prevalence of endoscopic signs and cirrhosis and to determine their diagnostic accuracy.

Methods

This prospective study was conducted from January 1997 to February 1999 in the National Hospital «Point G» and «Gabriel Touré» in Bamako (Mali). The diagnostic criteria for cirrhosis were liver histological examination or combination of an enlarged liver with thin lower edge, a decreased prothrombin index and an ultrasonographic or laparoscopic aspect of cirrhosis. Controls were chronic liver diseases without cirrhosis all proved by liver biopsy.

Results

At the end of the study, 116 patients were included with 56 cirrhosis and 60 non cirrhotic chronic liver diseases. Esophageal varices, PHT gastropathy and erosions were significantly more frequent in the cirrhosis group.

Nine variables were significantly different between the two groups and were included in a discrimnative analysis: HBs antigen, esophageal varices, erosion and jaundice were independently predictive with a diagnostic accuracy of 89% for cirrhosis.

Conclusion

This study, relying on a reference diagnostic method as laparoscopy, confirms that endoscopic signs have an independent diagnostic value for cirrhosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abbreviations

EVA:

ectasies vasculaires antrales

HTP:

hypertension portale

PBH:

ponction biopsie hépatique

TP:

taux de prothrombine

VO:

varices œsophagiennes

VCT:

varices cardio-tubérosistaires

Références

  1. BLOOM S.L., IRELAND A., RYLEY N.G., CHAPMAN R.W., LINDSELL D. — Correlation between hepatic ultrasound and histology.Eur. J. Gastroentrol. Hepatol., 1992,4, 39–42.

    Google Scholar 

  2. CALES P., PILETTE C., CROQUET V., VUILLEMIN E., OBERTI F. — Diagnostic précoce et non invasif de la cirrhose du foie.Enc. Med. Chir., 2000, 7-034-B-10.

  3. PILETTE C., CROQUET V., VUILLEMIN E., OBERTI F., CALÈS P. — Diagnostic précoce et non invasif de la cirrhose du foie.Gastroenterol. Clin. Biol., 1999,23, 657–665.

    Google Scholar 

  4. COULIBALY A. — Diagnostic non vulnérant de la cirrhose. Thèse, Med., Bamako, 1996, no 24.

  5. OBERTI F., VALSESIA E., PILETTE C., ROUSSELET M.C., BEDOSSA P., AUBÉ C.,et al. — Non invasive diagnostic of hepatic fibrosis or cirrhosis.Gastroenterology, 1997,113, 1609–1616.

    Article  PubMed  CAS  Google Scholar 

  6. OMS. Évaluation de la morbidité due àSchistosoma mansoni. WHO/OSHISTO OMS: 88–97.

  7. PAPAZIAN A., BRAILLON A., DUPAS J.P., SEVENT F., CAPRON J.P. — Portal hypertensive gastric mucosa. An endoscopic study.Gut, 1986,27, 1199–1203.

    Article  PubMed  CAS  Google Scholar 

  8. SOGODOGO S. — Étude histologique et échographique de la bilharziose hépatique à Bamako (à propos de 39 cas). Thèse, Méd., Bamako, 1993, no 52.

  9. BURTIN P., CALÈS P., OBERTI F., JOUNDY N., PERSON B., CARPENTIER S., BOYER J. — Endoscoic ultrasonographic signs of portal hypertension in cirrhosis.Gastrointest. Endosc., 1996,44, 257–261.

    Article  PubMed  CAS  Google Scholar 

  10. CALÈS P., ZABOTTO B., MESKENS C., CAUCANAS J.P., VINEL J.P., DESMORAT H., FERMANIAN J., PASCAL J.P. — Gastro-oesophageal endoscoic features in cirrhosis: observer variability, interassociations and relationship to hepatic dysfunction.Gastroenterology, 1990,98, 156–162.

    PubMed  Google Scholar 

  11. DUMAS O., LETARD J.C., RICHARD P., BARTHELEMY C., AUDIGIER J.C. — Échographie endoscopique haute et hypertension portale au cours de la cirrhose.Acta Endoscopica, 1995,25, 337–346.

    Article  Google Scholar 

  12. SARIN S.K., MISRA S.P., SINGAL A., THORAT V., BROOR S.L. — Evaluation of the incidence and significance of the “mosaïc pattern” in patients with cirrhosis, non cirrhotic portal fibrosis, and extrahepatic obstruction.Am. J. Gastroenterol., 1988,83, 1235–1239.

    PubMed  CAS  Google Scholar 

  13. MAIGA M.Y., TRAORE H.A., DEMBELE M., COULIBALY A., KALLE A., BAYO S., GUINDO A., DIALLO A.N. — Diagnostic non vulnérant de la cirrhose en milieu tropical.Acta endoscopica, 1998,28, 290.

    Google Scholar 

  14. NORD J.H. — Biopsy diagnosis of cirrhosis: blind percutaneous versus guided direct vision techniques. A review.Gastrointest. Endosc., 1982,28, 102–104.

    Article  PubMed  CAS  Google Scholar 

  15. COSTA M.A., MOLINA E.G., REDDY R.K., JEFFERS L., THOMAS Y., DIAZ G.,et al. — Diagnostic laparoscopy using conscious sedation: a prospective study of its hemodynamic effects in an ambulatory setting.Hepatology, 2000,32 (4Pt2): 231A.

    Google Scholar 

  16. OBERTI F., BURTIN P., MAIGA M., VALSESIA E., PILETTE C., CALÈS P. — Gastroesophageal endoscopic signs of cirrhosis: independent diagnostic accuracy; interassociation; and relationship to etiology and hepatic dysfunction.Gastrointest. Endosc., 1998,48, 148–157.

    Article  PubMed  CAS  Google Scholar 

  17. PAGLIARO L., RINALDI F., CRAXI A., DIFRANCO C., DI PIAZZA S., FILIPAZZO G.et al. — Predictive value of clinical, laparoscopic and histologic indicators of cirrhosis.Ital. J. Gastroenterol., 1982,14, 166–168.

    Google Scholar 

  18. GAIANI S., GRAMANTIERI L., VENTUROLI N., PISCAGLIA F., SIRINGO S., D'ERRICOet al. — What is the criterion for differentiating chronic hepatitis from compensated cirrhosis? A prospective study comparing ultrasonography and percutaneous liver biopsy.J. Hepatol., 1997,27, 979–985.

    Article  PubMed  CAS  Google Scholar 

  19. BAS V., CHAMPIGNEULLE B., AYMARD B., BIGARD M.A., GAUCHER P. — Étude prospective du score PGA pour le diagnostic des maladies alcooliques graves du foie.Gastroenterol. Clin. Biol., 1992,16, A232.

    Google Scholar 

  20. RABINOVITZ M., YOO Y.K., SCHADE R.K., DINDZNS V.J., VAN THIEL D.H., GAVALE J.S. — Prevalence of endocopic findings in 510 consecutive individuals with cirrhosis, evaluated prospectively.Dig. Dis. Sci., 1990,35, 705–710.

    Article  PubMed  CAS  Google Scholar 

  21. CALÈS P., PASCAL J.P. — Histoire naturelle des varices œsophagiennes au cours de la cirrhose (de la naissance à la rupture).Gastroenterol. Clin. Biol., 1988,12, 245–54.

    PubMed  Google Scholar 

  22. WEN J., FA-Y.L., HAN-CHIEH L., YANG-TE T., SHOUDONG L., KWOK-HUNG L.et al. — Snake skin pattern gastropathy in cirrhotic patients.J. Gastroenterol. Hepatol., 1991,6, 145–149.

    Article  Google Scholar 

  23. CALÈS P., BURTIN P., PERSON B., RUGET O., CHARLOIS T., FERRERO P.et al. — Interobserver agreement on endoscopic diagnosis of diffuse gastric mucosal features in cirrhotic patients.Eur. J. Gastroenterol. Hepatol., 1993,5, 263–268.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Service d'Hépato-gastroentérologie, Hôpital Gabriel Toure, (France)

    M. Y. Maiga, F. Diallo & A. Guindo

  2. Service de Médecine Interne, Hôpital du Point «G», BP 2931, Bamako, (Mali)

    M. Dembele, H. A. Traore & A. K. Traore

Authors
  1. M. Y. Maiga
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Dembele
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F. Diallo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. H. A. Traore
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. K. Traore
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A. Guindo
    View author publications

    You can also search for this author in PubMed Google Scholar

About this article

Cite this article

Maiga, M.Y., Dembele, M., Diallo, F. et al. Valeur diagnostique de l'endoscople digestive haute au cours de la cirrhose. Acta Endosc 32, 211–218 (2002). https://doi.org/10.1007/BF03016657

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03016657

Mots-clés

Key-words

Search

Navigation