Evaluation of therapeutic effects on rectal varices using percutaneous color Doppler ultrasonography

Sato, Takahiro; Yamazaki, Katsu; Toyota, Jouji; Karino, Yoshiyasu; Ohmura, Takumi; Akaike, Jun

doi:10.1111/j.1872-034x.2009.00505.x

Cited by 3 publications

(4 citation statements)

References 21 publications

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“…The detection of endoscopically inevident RVs was possible only by EUS in two cases, and potentially hazardous application of endoclips or coagulation methods on a bleeding point was avoided [1, 6, 7, 12]. The application of band on a normal looking mucosa on endoscopically inevident rectal varices stopped bleeding in a case of LGIB operated for internal hemorrhoids [8].…”

Section: Resultsmentioning

confidence: 99%

“…Endoscopic and EUS correlation of RVs has shown that RVs, classified as tortuous, nodular, and tumorous on endoscopic examination, have corresponding appearances on rectal EUS as single, multiple, and innumerable submucosal veins, respectively [11]. The hemodynamic evaluation (HDE) of RVs by EUS is routinely done at some centers to assess parameters like the site, size, velocity, or direction of flow [9, 12]. The HDE of these parameters can offer therapeutic advantage before the selection of endoscopic or interventional radiological therapy [13].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

EUS-Assisted Evaluation of Rectal Varices before Banding

Sharma

Rai²,

Bansal

2013

Gastroenterology Research and Practice

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Rectal varices are an important cause of bleed. The bleeding can be sometimes fatal. Endoscopic management is possible and is generally done in emergency situation. Rectal variceal banding is useful. Hemodynamic evaluation has shown that the blood flow in rectal varices is from above downwards; however, the site of banding of rectal varices is unclear. This case series shows that the rectal varices should be banded at the highest point of inflow.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

EUS-Assisted Evaluation of Rectal Varices before Banding

Sharma

Rai²,

Bansal

2013

Gastroenterology Research and Practice

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“…[ 47 ] Hemodynamic evaluation of rectal varices is routinely done at some centers by utilizing EUS to assess site, size, velocity, or direction of flow. [ 48 49 ] Sharma et al , reported a series of five patients in which 40% required EUS to identify EIRV. In the presence of LGIB, EUS prevented potentially hazardous application of clips or coagulation methods to control a bleeding point.…”

Section: Gastric Varicesmentioning

confidence: 99%

Endoscopic ultrasound guided vascular access and therapy (with videos)

Saxena

Lakhtakia

2015

Endosc Ultrasound

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The continued need to develop minimally invasive alternatives to surgical and radiologic interventions has driven the development of endoscopic ultrasound (EUS)-guided treatments. EUS has now stepped into the therapeutic arena. EUS provides the unique advantage of both real-time imaging and access to structures within and adjacent to the gastrointestinal (GI) tract. Hence, EUS-guided therapeutic techniques continue to evolve in several directions enabling a variety of minimally invasive therapies for pancreatic and biliary pathologies. Furthermore, the close proximity of the GI tract to vascular structures in the mediastinum and abdomen permits EUS-guided vascular access and therapy. Studies have demonstrated several EUS-guided vascular interventions by using standard endoscopic accessories and available tools from the interventional radiology armamentarium. This article provides an overview of the literature including clinical and nonclinical studies for the management of nonvariceal and variceal GI bleeding, formation of intrahepatic portosystemic shunts (IPSS), and EUS-guided cardiac access and therapy.

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“…2,10-12 On evaluation, the majority of symptomatic RVs are endoscopically evident, but sometimes bleeding occurs from submucosal endoscopically inevident (EIE) RVs 13 for which EUS is more sensitive. 14,15 Effective endoscopic management of RVs depends on evaluation of the site (generally middle and lower rectum), size (by endoscopic examination and EUS), velocity (slow or rapid flow), and direction of flow (hepatofugal or rarely hepatopetal). 14, 16 We describe here a case of EIE-RV with massive lower GI bleed that was diagnosed by color Doppler (CD)-EUS and managed by histoacryl glue injection.…”

mentioning

confidence: 99%