Endoscopic, ultrasonographic, and US-Doppler parameters as indicators of variceal bleeding in patients with schistosomiasis

Endoscopic, ultrasonographic, and US-Doppler parameters as indicators of variceal bleeding in patients with schistosomiasis

Autor Martins, R. D. Google Scholar
Szejnfeld, J. Google Scholar
Lima, F. G. Google Scholar
Ferrari, A. P. Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Resumo Bleeding from esophagogastric varices is a potentially deadly complication in patients with hepatosplenic schistosomiasis. the aim of this study is to establish indicators of variceal bleeding. We studied 40 patients with compensated hepatosplenic schistosomiasis and varices, analyzing four endoscopic (variceal size, red color signs, fundic var-ices, and congestive gastropathy), nine ultrasonographic (right and left hepatic lobe size, periportal and gallbladder wall thickness, portal and splenic veins diameter, spleen longitudinal axis and volume, and presence of collateral circulation), and five US-Doppler parameters (portal and splenic veins velocity and flaw and portal vein congestion index). Patients were divided in two groups according to previous history of variceal bleeding. the group with bleeding episodes was again divided in two groups: with and without treatment, namely endoscopic sclerotherapy. All endoscopic parameters and two ultrasonographic (periportal thickness and portal vein diameter) were statistically different between the groups with and without previous bleeding. the likelihood index, adopted to determine the best parameters related to previous bleeding showed that the most important combinations are: gastropathy and red signs followed by portal vein diameter and variceal size. in conclusion, although aware of the limits of the statistical analysis due to the small number of patients, our results demonstrated that endoscopic and US parameters (isolated or combined) can identify patients with a high risk of variceal bleeding, allowing physicians to optimize prophylactic therapy.
Palavra-chave hepatosplenic schistosomiasis
variceal bleeding
endoscopy
ultrasonography
US-Doppler
Idioma Inglês
Data de publicação 2000-05-01
Publicado em Digestive Diseases and Sciences. New York: Kluwer Academic/plenum Publ, v. 45, n. 5, p. 1013-1018, 2000.
ISSN 0163-2116 (Sherpa/Romeo, fator de impacto)
Publicador Kluwer Academic/plenum Publ
Extensão 1013-1018
Fonte http://dx.doi.org/10.1023/A:1005501930808
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000086701400029
Endereço permanente http://repositorio.unifesp.br/handle/11600/26307

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