Reliability of endoscopy in the assessment of variceal features

Pagliaro, Luigi; Spina, G. P.; D’Amico, Gennaro; Brocchi, Emilio; Caletti, G.; Cosentino, F.; Franchis, Roberto de; Giulio, Emilio Di; Rigo, Gianpiero; Zoli, Marco; Tinè, Fabio; Amuso, M.; Antona, Claudio; Buri, L.; Cucchiaro, Giovanni; Giovanni, Maria Di; Galeotti, F.; Gatto, G.; Magnani, Giacomo; Martines, Diego; Mazzanti, Roberto; Mosca, Piergiorgio; Opocher, Enrico; Santambrogio, Roberto; Taranto, Domenico; Traina, Mario; Ziparo, Vincenzo

doi:10.1016/s0168-8278(87)80015-6

Cited by 87 publications

(13 citation statements)

References 13 publications

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“…These figures are consistent with similar higher rates reported from the Egyptian literature [21] [22], and can be explained by the noncompliance of cirrhotic patients with the scheduled endoscopic screening in cirrhotics [20] and the bad reputation of IFN based therapies, were a large proportion of Egyptian patients canceled evaluation for IFN based therapies and were waiting the oral drugs. However, this study confirmed parallel increase [4] in the severity of varices (represented with increased grade) with advanced liver disease. This was noticeable by the higher prevalence of risky varices (grade II and III) in Child B patients compared to Child A patients, although the difference was not statically significant (p = 0.25).…”

Section: Discussionsupporting

confidence: 76%

“…The presence of varices correlates with the severity of liver disease; while in the previous international studies only 40% of Child A patients had varices; about 85% of Child C patients had varices [4]. In the current study about 65.9% and 69.5% of screened patients with Child A and B had varices respectively.…”

Section: Discussioncontrasting

confidence: 50%

“…Endoscopic grading of esophageal varices was carried out after the Italian liver cirrhosis project, in which varices are graded according to the proportion of the radius of the esophagus occupied by the largest varix present at full insufflations of the esophagus [4]. Grade1: Varices that collapse to inflation of the esophagus with air.…”

Section: Endoscopic Examinationsmentioning

confidence: 99%

“…Despite the significant improvements in the early diagnosis and treatment of esophagogastric variceal hemorrhage, the mortality rate of the first variceal hemorrhage remains high (20% -35%). Preventing first variceal hemorrhage offers the promise of reducing mortality, morbidity, and associated health care costs [3] [4]. Although many noninvasive parameters including routine liver biochemistry, esophageal wall thickness, and splenic diameter/platelet count ratio, APRI, Fibroscan of the spleen....etc.…”

Section: Introductionmentioning

confidence: 99%

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Validity of Upper Gastro-Intestinal Endoscopic Screening in HCV Cirrhotic Patients Awaiting Antiviral Therapy

Mohamed¹,

Gaballah²,

Emara³

2015

OJGas

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Background and Aim: The Egyptian Ministry of Health initiated a nationwide HCV treatment program with the newly developed oral antiviral therapies and formulated national guidelines for treatment allocation which gave favor for patients with advanced fibrosis and early cirrhosis. One of the recommendations for treatment was upper Gastro-intestinal (GIT) endoscopy. This study aimed at estimating the prevalence of varices among those patients and judging the validity of this national recommendation. Methods: This study was carried out at gastrointestinal endoscopy units, Zagazig University Hospitals through the year 2014. The epidemiologic, clinical features and endoscopic findings of patients undergoing preparation for HCV therapy were analyzed. Endoscopic classifications of esophageal and gastric varices were carried out after the Italian liver cirrhosis project and Sarin's classification respectively. Results: Totally 1143 patients performed upper GIT endoscopy as preparation for HCV treatment. This comprised 22% of all patients undergoing upper GIT endoscopy over that year. There was a fourfold rise in percentage of patients undergoing endoscopy for sofosbuvir-based therapy in this year (22%) when compared to assessment for Interferon/Ribavirin combination therapy (5%) in the previous year. A total of 331 patients had no esophageal or gastric varices. Small sized (grade I), medium sized (grade II) and large sized (grade III) varices were reported in 301, 188 and 293 patients respectively. Thirty patients (2.6%) had gastric varices. The prevalence of varices was higher in Child B in comparison to Child A (statistically not significant, p = 0.243). Conclusion: Screening endoscopy for early cirrhotic patients awaiting oral anti-HCV therapy is valid.

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Section: Discussionsupporting

confidence: 76%

Section: Discussioncontrasting

confidence: 50%

Section: Endoscopic Examinationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Validity of Upper Gastro-Intestinal Endoscopic Screening in HCV Cirrhotic Patients Awaiting Antiviral Therapy

Mohamed¹,

Gaballah²,

Emara³

2015

OJGas

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“…All patients underwent esophago-gastroduodenoscopy (EGDS) within 6 months before starting antiviral treatment and after had an EGDS repeated every 2 years by the same endoscopists (RdF, MP and AD), who were blinded to treatment outcome. EV were classified according to the North Italian Endoscopic Club criteria [11], size and location of EV and the presence of red wale marks (RWM) were assessed at all endoscopies [33]. Bleeding from EV or PHG was defined by the III Baveno International Consensus criteria [16].…”

Section: Upper Gastrointestinal Endoscopymentioning

confidence: 99%