Clin Endosc.  2012 Sep;45(3):324-327.

Usefulness of Endoscopic Ultrasound in Esophagogastric Varices

• Shim JJ

Abstract

Endoscopic ultrasound (EUS) is a useful diagnostic tool for evaluation of esophagogastric varices and guidance of endoscopic therapy. EUS can visualize not only collateral veins around the esophagus but also perforating veins that connect esophageal varices with collateral veins. They are associated with high risk of bleeding and early recurrence after initial variceal eradication. Isolated gastric varices can be easily diagnosed using EUS that mimic thickened gastric folds or subepithelial tumors. EUS-guided endoscopic therapy is a challenging field of variceal bleeding. It has a potential role for assistance of interventions and evaluation of treatment outcome.

Keyword

Endosonography; Esophageal and gastric varices; Portal hypertension

MeSH Terms

Endosonography
Esophageal and Gastric Varices
Esophagus
Hemorrhage
Hydrazines
Hypertension, Portal
Recurrence
Treatment Outcome
Varicose Veins
Veins
Hydrazines

Figure

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  Fig. 1 Esophageal varices. (A) Endoscopic image shows large esophageal varices. (B) Endoscopic ultrasound image shows esophageal varices (arrowheads) using a miniature probe (20 MHz) in the same patient.

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  Fig. 2 Gastric varices. (A) Endoscopic image shows large varices in the stomach. (B) Endoscopic ultrasound image shows same gastric varices. A tortuous hypoechoic tubular structure is seen in the submucosal layer.

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  Fig. 3 Endoscopic ultrasound images of collateral and perforating veins. (A) A collateral vein outside of the esophageal wall is seen (arrow head). (B) A perforating vein (arrowhead) that connects a collateral vein with an esophageal varix is seen.

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