Endoscopic ultrasonography at the choice of optimum medical tactics at esophagogastric varices

Objective of the study: Bleeding from esophagogastric varices is a catastrophic complication of chronic liver disease. Endoscopic ultrasonography can clearly depict vascular structures around the esophageal wall in patients with portal hypertension. The aim of this study was to determine role ultrasonography at a choice of optimum medical tactics at esophagogastric varices.

Methods and procedures: endoscopic variceal ligation at a bleeding from esophagogastric varices with II, III and IV item on Paquet it has been executed at 27 patients. Endoscopic ultrasonography it has been lead in 7–10 days after ligation by device Olympus UE 160 AL5 in dopler a mode.

Results: On the basis of the data ultrasonography it has been allocated three groups of patients with various variants of a blood-groove on veins of a esophagus. For 11 sick first groups were available wide (more than 1mm) perforating veins in the bottom third of esophagus in which the blood-groove from deep in undecutaneus veins is fixed. By this patient it has been executed repeated endoscopic variceal ligation in a zone of localization perforating veins. At the further supervision patients of this group went in the second and a third of group of patients. For 8 patients of the second group were available narrow (less than 1mm) perforating veins in the bottom third of esophagus in which it is not fixed regurgitashion blood from deep in undercutaneus veins. By this patient it was carried out one-stage endoscopic variceal ligation in a zone of localization perforating veins in a combination with argon plasma coagulation staying undercutaneus veins of a esophagus. At 8 patients allocated into third group to visualize perforating veins it was not possible also a blood-groove on undercutaneus to veins of a esophagus it was revealed not. This patient carried out argon plasma coagulation undercutaneus veins of a esophagus with the purpose of preventive maintenance of relapse esophageal variceal.

Conclusions: Application ultrasonography allows to establish more precisely indications to endoscopic variceal ligation and argon plasma coagulations at esophagogastric varices and to achieve full eradication veins of a esophagus.