Revista Colombiana de Gastroenterologia
Print version ISSN 0120-9957
GOMEZ, Diego et al. Várices esofágicas: experiencia clínica en un hospital de referencia regional. Rev Col Gastroenterol [online]. 2003, vol.18, n.1, pp. 20-23. ISSN 0120-9957.
Endoscopic studies show that the prevalence of oesophageal várices in cirrhotic patients is about 60%, while at 5 years probabilty to develop oesophageal várices reach 83%. In patients with oesophageal várices 20% experience a first upper gastrointestinal bleeding per year, which have a 30% mortality. It¨s estimate that about 40% of cirrhotic patients die for variceal bleeding. Objectives: 1. To describe the most frequent causes of oesophageal várices and the functional state (Child) of patientes who founded that in endoscopic evaluation. 2. To evaluate the complications, effectivity of endoscopic treatment and mortality in patientes with variceal bleeding. Material and methods: this is a descriptive study. We took all patients who experienced an upper GI endoscopy and found oesophageal várices, between 1 October 2000 and 31 December 2001. We determined the most frequent diagnoses, complications and mortality of these patients and applicate frequency distribution in percentage. Results: we collected 50 patients, of which 26 had a diagnostic endoscopy and 24 had a therapeutic endoscopy, for a total of 83 endoscopies, 55% male with 52 years old average . The grade of the várices is greater in the group of therapeutic procedures (Grade III Vs. Grade II of NIEC clasification). Ascitic fluid infection was present in 5% of diagnostic group Vs. 25% in therapeutic group. Endoscopic control of bleeding was reached in 97.5% of cases, 63% with banding, 29% with esclerotherapy and 8% with combined therapy. Reebleding was present in banding 46%, esclerotherapy 57% and 50% with combined therapy. The mortality in therapeutic group was 30% Vs. 0% in the diagnostic group and most of these patients had grade III várices (70%), ascitic fluid infection (86%) and Child C clasification (100%). Conclusion: mortality in patients with oesophageal várices is related directly with the self grade, advanced Child and presence of ascitic fluid infection.
Keywords : oesophageal várices; bleeding, banding; esclerotherapy; ascitis; infection; CHILD clasification.