Isolated Gastric Varices: Prevalence, Clinical Relevance and Natural HistorySarin S.K. · Jain A.K. · Lamba G.S. · Gupta R. · Chowdhary A.
Departments of Gastroenterology and Gastrointestinal Surgery, G.B. Pant Hospital, New Delhi, India
Background: Isolated ectopic gastric varices (IGV2) are present either in the body or antrum of the stomach or upper duodenum. The prevalence, natural history and clinical significance of these varices has not been adequately described. Materials and Methods: Consecutive patients with portal hypertension, prospectively studied and diagnosed to have IGV2, were assessed for their time of appearance – primary (at first presentation) or secondary (after obliteration of oesophageal varices), association with other varices, portal hypertensive gastropathy and any overt bleeding. Results: Fifty-three of the 1,128 (4.7%) patients had IGV2. The IGV2 were commonly seen in the antrum (53%), duodenum (32%), or at both sites (11%) and rarely in body and fundus (4%). IGV2 were predominantly (84.9%) secondary in origin, developing after oesophageal variceal obliteration. The median time for emergence of secondary IGV2 was 8.2 months for patients with cirrhosis, 12.8 months for non-cirrhotic portal fibrosis and 10.8 months for extra-hepatic portal vein obstruction. Eight (15%) patients had primary IGV2, 6 of them had underlying portal vein obstruction. Portal gastropathy (p < 0.05) and UGI bleeding were more common in the secondary than in primary IGV2. Bleeding due to IGV2 was seen only in 3 (5.7%) patients during a mean follow-up of 36.3 ± 12.1 months, and could be successfully managed with endoscopic ligation or obliteration. Conclusions: Isolated ectopic gastric varices are not uncommon and generally develop following obliteration of main variceal columns. They rarely bleed and often can be managed with endoscopic interventions.
© 2003 S. Karger AG, Basel
Received: January 8, 2001
Accepted: August 12, 2002
Number of Print Pages : 6
Number of Figures : 1, Number of Tables : 3, Number of References : 29
Official Publication of the International Society for Digestive Surgery (ISDS, formerly CICD), European Digestive Surgery (EDS), Dutch Society of Gastro-Intestinal Surgery (NVGIC), Japanese Society of Gastroenterological Surgery (JSGS), Hellenic Society for Digestive Surgery (HSDS)
Vol. 20, No. 1, Year 2003 (Cover Date: 2003)
Journal Editor: M.W. Büchler, Heidelberg; J.P. Neoptolemos, Liverpool
ISSN: 0253–4886 (print), 1421–9983 (Online)
For additional information: http://www.karger.com/dsu