Heat‐Probe Coagulation Treatment of Recurrent Intramucosal Venous Dilatation of the Esophagus and Endoscopic Color Doppler Ultrasonographic Follow‐up

Abstract

We treated 14 patients with high risk intramucosal venous dilatation (high risk IMVD) of esophageal varices using heat‐probe coagulation. Two of the 14 patients experienced bleeding from the high risk IMVD. We used an Olympus heat‐probe unit CD‐20Z to stop or prevent variceal bleeding. The 14 patients were treated one to four times (mean: 1.9 times) using a total of 450–2100 joules (mean: 1459 joules). The high risk IMVD disappeared with healing of the heat‐probe‐induced ulcers. No severe side effects were recorded. Two patients with bleeding from high risk IMVD were successfully treated by the heat‐probe technique. In addition, we studied the effects of endoscopic heat‐probe coagulation for esophageal varices via endoscopic color Doppler ultrasonography (ECDUS) in six patients. Our ECDUS study was conducted with a PENTAX FG‐32UA, 7.5MHz convex type, and a HITACHI EUB 565 display monitor. Following heat‐probe treatment, the esophageal walls thickened from 5.1 to 8 mm (mean: 6.3 mm) and a low echoic pattern was visualized by ECDUS. Esophageal intramural blood flow was not observed in any of the six patients. Paraesophageal veins and passageways remained patent in all six patients.

Value of endoscopic color doppler ultrasonography in endoscopic injection sclerotherapy‐resistant esophageal varices

“…We previously reported on the usefulness of ECDUS for evaluating the hemodynamics of esophageal varices. [5][6][7] In the present esophageal variceal case, passageways of esophageal varices were mainly associated with an inflowing perforating vein at the lower esophagus, and ECDUS was very useful for evaluation of hemodynamics. We herein report the details of this case.…”

“…It can graphically show esophageal varices, paraesophageal veins and passageways. We previously reported on the usefulness of ECDUS for evaluating the hemodynamics of esophageal varices 5–7 …”

Evaluation of the hemodynamics of rectal varices by endoscopic ultrasonography

“…5,6 On the other hand, we have reported the usefulness of endoscopic color Doppler ultrasonography (ECDUS) in patients with esophagogastric varices. [7][8][9] With ECDUS, color flow images in blood vessels can be obtained, and ECDUS allows for more detailed observation of the hemodynamics of esophagogastric varices than EUS. In this study, we examined the usefulness of ECDUS for evaluating hemodynamics in cases of rectal varices, and we compared blood flow velocities between rectal varices and esophageal varices.…”

Evaluation of the alternate blood FLow in esophageal variceal patients by endoscopic color Doppler ultrasonography

“…Endoscopic color Doppler ultrasonography (ECDUS) is a useful method of obtaining color flow images of blood vessels. We previously reported the utility of ECDUS in patients with esophagogastric varices 4–7 . We have been able to obtain color flow images that graphically demonstrate esophageal varices, paraesophageal veins, and perforating veins in patients with esophageal varices.…”

“…We previously reported the utility of ECDUS in patients with esophagogastric varices. [4][5][6][7] We have been able to obtain color flow images that graphically demonstrate esophageal varices, paraesophageal veins, and perforating veins in patients with esophageal varices. The direction of blood flow in the left gastric vein is fundamentally hepatofugal flow with ECDUS.…”