ENDOSCOPIC OBSERVATION OF ESOPHAGEAL VARICES AND ITS CLINICAL SIGNIFICANCE.

Abstract

Endoscopic classification of esophageal varices proposed by Japanese Portal Surgery Meeting was applied to 170 cases with portal hypertension for the purpose of determining which signs are useful in predicting variceal bleeding. The summarized conclusions are as follows: (1) Among 54 actively bleeding sources, esophago-gastric varices (48.1%) and hemorrha-gic gastritis (33.3%) were the most frequent. (2) Variceal bleeding was observed in 38% of stage 3 cases. Especially, in stage 3 cases with hematocystic spot, variceal bleeding was most frequently seen (78.5%). Thus, the hematocystic spot was thought to be the most important endoscopic sign to foresee the variceal bleeding. (3) As the result of endoscopic observations of varices for more than a year, an endoscopic examination should be performed once a year in stage 1 and once every 6 months in stage 2. (4) Follow-up study of esophageal varices suggested the necessity for prophylactic operation on varices not only in stage 3, but also on combined nodular and blue varices.