The Clinical Role of Endoscopic Ultrasound for Management of Bleeding Esophageal Varices in Liver Cirrhosis
Bleeding esophageal varices (BEV) is a serious clinical condition and can potentially be life-threatening. Esophageal varices are caused by abnormal dilated submucosal and collateral veins in the esophagus wall as a result of portal hypertension due to liver cirrhosis. Consequently, it is important...
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| Format: | Article |
| Language: | English |
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Karger Publishers
2022-05-01
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| Series: | Case Reports in Gastroenterology |
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| Online Access: | https://www.karger.com/Article/FullText/524529 |
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| author | Kemal Fariz Kalista Syifa Amalia Hanif Saut Horas Nababan Cosmas Rinaldi Adithya Lesmana Irsan Hasan Rino Gani |
| author_facet | Kemal Fariz Kalista Syifa Amalia Hanif Saut Horas Nababan Cosmas Rinaldi Adithya Lesmana Irsan Hasan Rino Gani |
| author_sort | Kemal Fariz Kalista |
| collection | DOAJ |
| description | Bleeding esophageal varices (BEV) is a serious clinical condition and can potentially be life-threatening. Esophageal varices are caused by abnormal dilated submucosal and collateral veins in the esophagus wall as a result of portal hypertension due to liver cirrhosis. Consequently, it is important to administer appropriate preventive treatment for the disease in order to decrease morbidity and mortality rates. The current gold standard to identify esophageal varices is the use of esophagogastroduodenoscopy (EGD). However, EGD has limitations due to its inability in observing detailed information of varices morphology and esophagogastric hemodynamics. This report shares the potential role of endoscopic ultrasound (EUS) to overcome the limitation of EGD in clinical practices. Two cases of BEV in hepatitis B liver cirrhosis patients were described in the report. In case 1, large esophageal varices were found through EGD, and large paraesophageal varices were found through EUS. In case 2, small esophageal varices were found through EGD, and submucosal varices with a large periesophageal collateral vein and perforating vein in the distal esophagus were found through EUS. Cyanoacrylate injection guided by EUS was performed in both cases, and no rebleeding occurred after the procedure. In these cases, we showed that EUS is proven to be a potential tool in diagnosis and management of BEV in liver cirrhosis. EUS provides more accurate diagnostic aspects to find varices, assess bleeding risk, and predict bleeding recurrence. EUS also provides more beneficial treatment aspects to guide the treatment procedure and to monitor post treatment response. |
| first_indexed | 2024-04-13T19:58:04Z |
| format | Article |
| id | doaj.art-27c594e13b904dc68d441c8139edb7b9 |
| institution | Directory Open Access Journal |
| issn | 1662-0631 |
| language | English |
| last_indexed | 2024-04-13T19:58:04Z |
| publishDate | 2022-05-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Gastroenterology |
| spelling | doaj.art-27c594e13b904dc68d441c8139edb7b92022-12-22T02:32:16ZengKarger PublishersCase Reports in Gastroenterology1662-06312022-05-0116229530010.1159/000524529524529The Clinical Role of Endoscopic Ultrasound for Management of Bleeding Esophageal Varices in Liver CirrhosisKemal Fariz KalistaSyifa Amalia HanifSaut Horas NababanCosmas Rinaldi Adithya LesmanaIrsan HasanRino Ganihttps://orcid.org/0000-0003-4009-7938Bleeding esophageal varices (BEV) is a serious clinical condition and can potentially be life-threatening. Esophageal varices are caused by abnormal dilated submucosal and collateral veins in the esophagus wall as a result of portal hypertension due to liver cirrhosis. Consequently, it is important to administer appropriate preventive treatment for the disease in order to decrease morbidity and mortality rates. The current gold standard to identify esophageal varices is the use of esophagogastroduodenoscopy (EGD). However, EGD has limitations due to its inability in observing detailed information of varices morphology and esophagogastric hemodynamics. This report shares the potential role of endoscopic ultrasound (EUS) to overcome the limitation of EGD in clinical practices. Two cases of BEV in hepatitis B liver cirrhosis patients were described in the report. In case 1, large esophageal varices were found through EGD, and large paraesophageal varices were found through EUS. In case 2, small esophageal varices were found through EGD, and submucosal varices with a large periesophageal collateral vein and perforating vein in the distal esophagus were found through EUS. Cyanoacrylate injection guided by EUS was performed in both cases, and no rebleeding occurred after the procedure. In these cases, we showed that EUS is proven to be a potential tool in diagnosis and management of BEV in liver cirrhosis. EUS provides more accurate diagnostic aspects to find varices, assess bleeding risk, and predict bleeding recurrence. EUS also provides more beneficial treatment aspects to guide the treatment procedure and to monitor post treatment response.https://www.karger.com/Article/FullText/524529bleeding esophageal varicesendoscopic ultrasoundliver cirrhosis |
| spellingShingle | Kemal Fariz Kalista Syifa Amalia Hanif Saut Horas Nababan Cosmas Rinaldi Adithya Lesmana Irsan Hasan Rino Gani The Clinical Role of Endoscopic Ultrasound for Management of Bleeding Esophageal Varices in Liver Cirrhosis Case Reports in Gastroenterology bleeding esophageal varices endoscopic ultrasound liver cirrhosis |
| title | The Clinical Role of Endoscopic Ultrasound for Management of Bleeding Esophageal Varices in Liver Cirrhosis |
| title_full | The Clinical Role of Endoscopic Ultrasound for Management of Bleeding Esophageal Varices in Liver Cirrhosis |
| title_fullStr | The Clinical Role of Endoscopic Ultrasound for Management of Bleeding Esophageal Varices in Liver Cirrhosis |
| title_full_unstemmed | The Clinical Role of Endoscopic Ultrasound for Management of Bleeding Esophageal Varices in Liver Cirrhosis |
| title_short | The Clinical Role of Endoscopic Ultrasound for Management of Bleeding Esophageal Varices in Liver Cirrhosis |
| title_sort | clinical role of endoscopic ultrasound for management of bleeding esophageal varices in liver cirrhosis |
| topic | bleeding esophageal varices endoscopic ultrasound liver cirrhosis |
| url | https://www.karger.com/Article/FullText/524529 |
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