Relationship between developement of para-esophageal vein and early recurrence of esophageal varices after endoscopic treatment

Abstract

We examined a relationship between the size of para-esophageal vein (PEV) visualized by computed tomography (CT) and early variceal recurrence after endoscopic treatment. Forty-two patients who underwent endoscopic injection sclerotherapy (EIS) or endoscopic variceal ligation (EVL) were divided into a PEV development group and a PEV non-development group according to the diameter of PEV on portal phase of dynamic multi-phase CT. Early recurrence was defined as endoscopic recurrence within 6 months after EIS or EVL. PEV was visualized as porto-systemic collaterals in all patients on the CT image. An early recurrence rate was significantly lower in the PEV development group (6%) than the PEV non-development group (38%). This result suggests that PEV is a drainage vein to reduce portal pressure, and that developed PEV plays an important role to prevent variceal recurrence. The result also indicates that dynamic CT is a useful modality for evaluating PEV, and it gives us useful information to estimate early recurrence after EIS or EVL.