Difference between type 2 gastroesophageal varices and isolated fundic varices in clinical profiles and portosystemic collaterals  

作　　者：Yu-Hu Song Hong-Yu Xiang Ke-Ke Si Ze-Hui Wang Yu Zhang Chang Liu Ke-Shu Xu Xin Li 

机构地区：[1]Department of Gastroenterology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,Hubei Province,China [2]Department of Radiology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,Hubei Province,China [3]Hubei Province Key Laboratory of Molecular Imaging,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,Hubei Province,China

出　　处：《World Journal of Clinical Cases》2022年第17期5620-5633,共14页世界临床病例杂志

基　　金：Supported by National Natural Science Foundation of China,No.82070631.

摘　　要：BACKGROUND There is significant heterogeneity between gastroesophageal varices(GOV2)and isolated gastric varices(IGV1).The data on the difference between GOV2 and IGV1 are limited.AIM To determine the etiology,clinical profiles,endoscopic findings,imaging signs,portosystemic collaterals in patients with GOV2 and IGV1.METHODS Medical records of 252 patients with gastric fundal varices were retrospectively collected,and computed tomography images were analyzed.RESULTS Significant differences in routine blood examination,Child-Pugh classification and MELD scores were found between GOV2 and IGV1.The incidence of peptic ulcers in patients with IGV1(26.55%)was higher than that of GOV2(11.01%),while portal hypertensive gastropathy was more commonly found in patients with GOV2(22.02%)than in those with IGV1(3.54%).Typical radiological signs of cirrhotic liver were more commonly observed in patients with GOV2 than in those with IGV1.In patients with GOV2,the main afferent vessels were via the left gastric vein(LGV)(97.94%)and short gastric vein(SGV)(39.18%).In patients with IGV1,the main afferent vessels were via the LGV(75.61%),SGV(63.41%)and posterior gastric vein(PGV)(43.90%).In IGV1 patients with pancreatic diseases,spleno-gastromental-superior mesenteric shunt(48.15%)was a major collateral vessel.In patients with fundic varices,the sizes of gastric/esophageal varices were positively correlated with afferent vessels(LGVs and PGVs)and efferent vessels(gastrorenal shunts).The size of the esophageal varices was negatively correlated with gastrorenal shunts in GOV2 patients.CONCLUSION Significant heterogeneity in the etiology and vascular changes between GOV2 and IGV1 is useful in making therapeutic decisions.

关 键 词：Gastrorenal shunt Spleno-gastroomental-superior mesenteric shunt Liver cirrhosis Pancreatic diseases 

分 类 号：R571.3[医药卫生—消化系统]