Acute bleeding from gastroesophageal varices is a medical emergency that, despite the progress in management achieved in recent years, still carries a 6-weeks mortality of 10% or higher. Nowadays, effective treatments to prevent the first variceal hemorrhage and to treat bleeding exist. For these reasons, several studies have been carried out to identify those patients at high risk for a first variceal hemorrhage, in order to select them for prophylactic therapy. Over the last 50 years, endoscopy has extensively been used to diagnose and classify portal hypertension related lesions, including esophageal end gastric varices and portal hypertensive gastropathy. This chapter describes the endoscopic methods used to diagnose these lesions and the results of studies aimed at stratifying patients into risk classes for bleeding.
KeywordsEsophageal varices Gastric varices Portal hypertensive gastropathy Red color signs Prognostic scores
- 7.Sarin SK. Diagnostic issues: portal hypertensive gastropathy and gastric varices. In: de Franchis R, editor. Portal hypertension II. Proceedings of the second Baveno international consensus workshop on definitions, methodology and therapeutic strategies. Oxford: Blackwell; 1996. p. 30–55.Google Scholar
- 8.Carpinelli L, Primignani M, Preatoni P, Angeli P, Battaglia G, Beretta L, et al. Portal hypertensive gastropathy: reproducibility of a classification, prevalence of elementary lesions, sensitivity and specificity in the diagnosis of cirrhosis of the liver. A NIEC multicentre study. New Italian Endoscopic Club. Ital J Gastroenterol Hepatol. 1997;29:533–40.PubMedGoogle Scholar
- 13.Eisen GM, Eliakim R, Zaman A, Schwartz J, Faigel D, Rondonotti E, Villa F, Weizman E, Yassin K, deFranchis R. The accuracy of PillCam ESO capsule endoscopy versus conventional upper endoscopy for the diagnosis of esophageal varices: a prospective three-center pilot study. Endoscopy. 2006;38:31–5.CrossRefPubMedGoogle Scholar