Abstract
We conducted a retrospective study to determine the indication of preventive endoscopic injection sclerotherapy (EIS) for isolated gastric varices (i-GV). For this purpose, endoscopic findings of patients with hemorrhagic i-GV were compared with those of patients with non-hemorrhagic i-GV. We investigated risk factors for variceal bleeding based on endoscopic findings and sought vascular factors relating to recurrence i-GV using endoscopic ultrasonography. Findings to predict recurrence of i-GV and rebleeding from the i-GV after EIS were selected. Largeness in size, a positive red color sign and erosions on i-GV were characteristically found in patients with hemorrhagic i-GV. Comparison of findings on endoscopic ultrasonography between patients with recurrence of i-GV and those without recurrence of i-GV revealed that aechoic lumens corresponding to perforating veins and peri-gastric collateral veins around the gastric serosa were significantly more often found in patients with hemorrhagic i-GV than in patients without recurrence of i-GV. Since massive hemorrhage from i-GV results in a poor prognosis. Thus, additional EIS is necessary to prevent recurrence and re-bleeding from i-GV when these risk factors were found after initial EIS.
