Esophageal Varices: Evaluation with Esophagography with Barium versus Endoscopic Gastroduodenoscopy in Patients with Compensated Cirrhosis—Blinded Prospective Study

Farber, Evgeny; Fischer, Doron; Eliakim, Rami; Beck-Razi, Nira; Engel, Ahuva; Veitsman, Ella; Chermesh, Irit; Yassin, Kamel; Gaitini, Diana; Libes, Michael; Linn, Shai; Soboh, Soboh; Baruch, Yaacov

doi:10.1148/radiol.2372041631

Cited by 14 publications

(4 citation statements)

References 47 publications

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“…Esophagography has positive predictive value, negative predictive value, and accuracy of 89%, 83%, and 87%, respectively, and can be considered as a useful noninvasive method for patients to undergo prophylactic treatment. 12 CT is a potential tool for noninvasive risk stratification of esophageal varices. Patients whose esophageal varices measure more than 5 mm at CT are more likely to have variceal hemorrhage.…”

Section: Igv2mentioning

confidence: 99%

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Imaging of Portal Gastroduodenopathy

Helavar

Ramappa

Wali

2021

Journal of Gastrointestinal and Abdominal Radiology

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Portal hypertension is characterized by elevated pressure in portal venous system due to portal resistance due to various causes. The etiologies are either pre-hepatic, hepatic, or post-hepatic. Elevated portal pressure results in varices at various sites some of which are difficult to identify on endoscopy alone. Other manifestations of elevated portal pressure include portal gastropathy, enteropathy, colopathy, gastric antral vascular ectasia, and ascites. Imaging plays an essential role in diagnosis and imaging of various manifestations of portal hypertension by determining the locations of varices and plan the management for same. Endoscopy helps in visualizing mucosal varices but newer imaging modalities give a panoramic extent of the disease in the entire gastrointestinal tract with great specificity and sensitivity. Initially, Barium study was used to determine esophageal or gastric varices, computed tomography provides detailed anatomic information which can be used to plan management. Due to advancement in imaging and interventional techniques, treatment for varices has seen advent of multiple minimally invasive interventional radiological techniques. A brief outlook on anatomical aspect of varices and various recent advances in management of the same has been provided. Overall knowledge of the various imaging manifestations of portal hypertension can be helpful to evaluate prognosis and plan proper management.

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Section: Igv2mentioning

confidence: 99%

“…Fig 12. Venogram from BRTO procedure (same patient as in Fig.6) demonstrates balloon (thick arrow) inflated in the caudal gastrorenal shunt with filling of the vertical segment (dotted arrow) of the shunt and tortuous extragastric (false) and intragastric (true) varices (thin arrow).…”

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confidence: 93%

Imaging of Portal Gastroduodenopathy

Helavar

Ramappa

Wali

2021

Journal of Gastrointestinal and Abdominal Radiology

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“…The Cruveilhier Baumgarten disease is reserved for cases with congenital patency of the umbilical vein associated with congenital hypoplasia of the liver and portal system and a venous murmur heard over the umbilical vein (1) . (3,4,5) Ethical Clearance-Taken from ethical committee of institution…”

Section: Introductionmentioning

confidence: 99%

Courveilhier Baumgarten Syndrome: A Rare Case Report

Rajinder Sharma,

Shivjeet Yadav,

Lakshya Yadav

et al. 2022

IJPHRD

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“…In human medicine, videoendoscopy is considered to be the reference standard in the detection and bleeding risk evaluation of esophageal and gastric varices. 20,21 The high mortality rate associated with esophageal variceal bleeding in humans has made early identification of potentially dangerous varices a clinical priority. 22,23 The main endoscopic parameters by which dangerous varices are identified are variceal diameter and appearance.…”

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confidence: 99%

Esophageal Varices Due to a Probable Arteriovenous Communication in a Dog

Bertolini¹,

Lorenzi²,

Ledda³

et al. 2007

J Vet Int Med

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A 6-year-old 40-kg castrated male Samoyed dog was presented for evaluation of chronic remittent lameness of the right forelimb. The dog had a history of polyuria-polydipsia (PU/PD) and lethargy over the previous year. Physical examination was unremarkable except for a grade II systolic murmur at the apex of the heart on the left side. A 6-lead ECG was within normal limits. Arterial blood gas analysis indicated mild respiratory alkalosis (pH, 7.457, reference range, 7.370-7.450 Thoracic radiographs disclosed a generalized increase in the size of the cardiac silhouette and pulmonary vascular enlargement, suggesting pulmonary overcirculation. An ELISA for Dirofilaria immitis antigen was negative. Two-dimensional, M-mode echocardiography a (transducer frequency, 2.0-3.0 MHz) revealed left atrial enlargement, left ventricular eccentric hypertrophy, and impaired systolic function (end-diastolic dimension, 65.7 mm; end-systolic dimension, 44.2 mm; shortening fraction, 32.7%) with normal valves. Spectral and colorflow Doppler examination disclosed mild mitral, aortic, and pulmonic valve insufficiency. Both the tricuspid and the telediastolic pulmonic valvular peak regurgitant jet velocities were increased as follows: 3.26 m/s (normal, #2.5 m/s) and 2.44 m/s (normal, #2.0 m/s), respectively. According to the Bernoulli's equation modification, the systolic pulmonary artery pressure was estimated to be 42.5 mm Hg and the diastolic pulmonary artery pressure was estimated to be 23.9 mm Hg, values consistent with mild pulmonary hypertension.The dog was anesthetized and subjected to radiography of the right forelimb and total body multidetector computed tomography b (MDCT). The radiographs were negative for abnormalities, and synovial fluid examination of the shoulder and stifle joints did not indicate evidence of any inflammatory pathology. MDCT scans of the brain, thorax, and abdomen were obtained. For the thoracic and abdominal scans, the dog was positioned in dorsal recumbency, and we employed the following parameters: helical modality, 120 kV, 200 mA, 0.7-second rotation tube, 0.526 pitch, and 1.2-mm slice thickness. For the brain scan, the dog was positioned in sternal recumbency and the scanner parameters were as follows: axial modality, 120 kV, 310 mA, 2-second rotation tube, 0.625 slice thickness, and 10-mm intervals. For an enhanced series, 2-mL/kg iodixanol c 320 mg I/mL was injected via a 22-gauge catheter into the right cephalic vein at a 3 mL/second infusion rate, through a computed tomography injector system. d The brain and abdominal MDCT scans were normal. However, MDCT of the neck and chest revealed 12 pairs of ribs, an enlarged heart, and enlarged pulmonary vessels. Both of the bronchoesophageal arteries were enlarged and connected with an enormous network of homogeneously enhancing serpentine structures involving the thoracic esophagus (esophageal and paraesophageal varices). The bronchoesophageal vein was extremely dilated (Figs 1, 2). The right azygous and hemizygous veins were normal. The cranial vena ca...

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Esophageal Varices: Evaluation with Esophagography with Barium versus Endoscopic Gastroduodenoscopy in Patients with Compensated Cirrhosis—Blinded Prospective Study

Abstract: Esophagography is highly accurate in diagnosis of EV and can be considered a viable noninvasive alternative for determination of patients who should be selected for prophylactic treatment.

Cited by 14 publications

References 47 publications

Imaging of Portal Gastroduodenopathy

Imaging of Portal Gastroduodenopathy

Courveilhier Baumgarten Syndrome: A Rare Case Report

Esophageal Varices Due to a Probable Arteriovenous Communication in a Dog

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