Gastrointestinal varices other imaging findings: Difference between revisions
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{{Gastrointestinal varices}} | {{Gastrointestinal varices}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}} {{HK}} | ||
==Overview== | ==Overview== | ||
[[Upper endoscopy]] may be helpful in the [[diagnosis]] of [[esophageal varices|gasteroesophageal varices]]. Findings on an [[upper endoscopy]] diagnostic of [[esophageal varices]] include visible [[submucosal]] tortuous veins, congested [[veins]] without compression during air [[insufflation]], and grape-like [[varicose veins|varicose]] veins that may occlude the [[lumen]]. Three dimensional [[portal]] [[venography]] may be helpful in the diagnosis of [[esophageal varices|gasteroesophageal varices]]. Findings on a [[portal]] [[venography]] diagnostic of [[esophageal varices]] include reverse flow in [[Portocaval anastomoses|porto-systemic shunts]], [[collateral]] [[Vein|veins]] draining into [[inferior vena cava|inferior vena cava (IVC)]], and other [[collateral]] [[veins]]. | |||
==Other Imaging Findings== | |||
===Fluoroscopic-guided esophagography=== | |||
== | '''Mucosal relief views''' | ||
Mucosal relief views may exhibit the following findings: | |||
*Tortuous, serpiginous, longitudinal radiolucent filling defects in collapsed or partially collapsed esophagus | |||
'''Double-contrast study''' | |||
Double-contrast study may show the following findings: | |||
*Multiple radiolucent filling defects etched in white | |||
{| align="right" | |||
|[[image:OEV wale.jpg|thumb|300px|Esophageal varices-By Samir, via Wikimedia Commons<ref><"https://commons.wikimedia.org/wiki/File%3AEsophageal_varices_-_wale.jpg">via Wikimedia Commons</ref>]] | |||
|[[image:Gastric Varices.jpg|thumb|350px|Gastric varices-By Jeremias (Own work), via Wikimedia Commons<ref><"https://commons.wikimedia.org/wiki/File%3AGastric_Varices.jpg">via Wikimedia Commons</ref>]] | |||
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|[[image:Venography.png|thumb|400px|Venography Source:Open-i<ref>{{cite web |url=https://openi.nlm.nih.gov/detailedresult.php?img=PMC3859884_kjped-56-500-g001&req=4 |title=(A) Angiographic portography revealed portal vein, coro | Open-i |format= |work= |accessdate=}}</ref>]] | |||
|[[image:Portal-vein-anatomy.jpg|thumb|350px|Venography-Case courtesy of Dr Omar Bashir, via radiopaedia.org<ref name="https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/16761">rID: 16761</ref>]] | |||
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=== Upper endoscopy === | |||
* [[Upper endoscopy]] may be helpful in the [[diagnosis]] of [[Esophageal varices|gasteroesophageal varices]]. | |||
* Findings on an [[upper endoscopy]] diagnostic of [[esophageal varices]] include:<ref name="pmid27324725">{{cite journal| author=Abby Philips C, Sahney A| title=Oesophageal and gastric varices: historical aspects, classification and grading: everything in one place. | journal=Gastroenterol Rep (Oxf) | year= 2016 | volume= 4 | issue= 3 | pages= 186-95 | pmid=27324725 | doi=10.1093/gastro/gow018 | pmc=4976684 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27324725 }}</ref> | |||
** Visible [[submucosal]] tortuous veins | |||
** Congested [[veins]] without compression during air [[insufflation]] | |||
** Grape-like [[Varicose veins|varicose]] veins that may occlude the [[lumen]]<ref name="pmid8076547">{{cite journal |vauthors=Thakeb F, Salem SA, Abdallah M, el Batanouny M |title=Endoscopic diagnosis of gastric varices |journal=Endoscopy |volume=26 |issue=3 |pages=287–91 |year=1994 |pmid=8076547 |doi=10.1055/s-2007-1008969 |url=}}</ref> | |||
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=== Three dimensional portal venography === | |||
* Three dimensional [[portal]] [[venography]] may be helpful in the diagnosis of [[Esophageal varices|gasteroesophageal varices]]. | |||
* Findings on a [[portal]] [[venography]] diagnostic of [[esophageal varices]] include:<ref name="pmid18373819">{{cite journal| author=Agarwal A, Jain M| title=Multidetector CT portal venography in evaluation of portosystemic collateral vessels. | journal=J Med Imaging Radiat Oncol | year= 2008 | volume= 52 | issue= 1 | pages= 4-9 | pmid=18373819 | doi=10.1111/j.1440-1673.2007.01903.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18373819 }}</ref><ref name="pmid12235335">{{cite journal| author=Kang HK, Jeong YY, Choi JH, Choi S, Chung TW, Seo JJ et al.| title=Three-dimensional multi-detector row CT portal venography in the evaluation of portosystemic collateral vessels in liver cirrhosis. | journal=Radiographics | year= 2002 | volume= 22 | issue= 5 | pages= 1053-61 | pmid=12235335 | doi=10.1148/radiographics.22.5.g02se011053 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12235335 }}</ref> | |||
** Reverse flow in [[Portocaval anastomoses|porto-systemic shunts]] | |||
** [[Collateral]] [[Vein|veins]] draining into [[Inferior vena cava|inferior vena cava (IVC)]] | |||
** Other [[collateral]] [[veins]] | |||
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==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Gastroenterology]] | |||
[[Category:Hepatology]] | |||
[[Category:Disease]] | |||
[[Category:Emergency medicine]] | |||
{{WH}} | |||
{{WS}} |
Latest revision as of 16:14, 5 January 2018
Gastrointestinal varices Microchapters |
Differentiating Gastrointestinal varices from other Diseases |
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Diagnosis |
Treatment |
Case Studies |
Gastrointestinal varices other imaging findings On the Web |
American Roentgen Ray Society Images of Gastrointestinal varices other imaging findings |
Risk calculators and risk factors for Gastrointestinal varices other imaging findings |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]
Overview
Upper endoscopy may be helpful in the diagnosis of gasteroesophageal varices. Findings on an upper endoscopy diagnostic of esophageal varices include visible submucosal tortuous veins, congested veins without compression during air insufflation, and grape-like varicose veins that may occlude the lumen. Three dimensional portal venography may be helpful in the diagnosis of gasteroesophageal varices. Findings on a portal venography diagnostic of esophageal varices include reverse flow in porto-systemic shunts, collateral veins draining into inferior vena cava (IVC), and other collateral veins.
Other Imaging Findings
Fluoroscopic-guided esophagography
Mucosal relief views
Mucosal relief views may exhibit the following findings:
- Tortuous, serpiginous, longitudinal radiolucent filling defects in collapsed or partially collapsed esophagus
Double-contrast study
Double-contrast study may show the following findings:
- Multiple radiolucent filling defects etched in white
Upper endoscopy
- Upper endoscopy may be helpful in the diagnosis of gasteroesophageal varices.
- Findings on an upper endoscopy diagnostic of esophageal varices include:[5]
- Visible submucosal tortuous veins
- Congested veins without compression during air insufflation
- Grape-like varicose veins that may occlude the lumen[6]
Three dimensional portal venography
- Three dimensional portal venography may be helpful in the diagnosis of gasteroesophageal varices.
- Findings on a portal venography diagnostic of esophageal varices include:[7][8]
- Reverse flow in porto-systemic shunts
- Collateral veins draining into inferior vena cava (IVC)
- Other collateral veins
References
- ↑ <"https://commons.wikimedia.org/wiki/File%3AEsophageal_varices_-_wale.jpg">via Wikimedia Commons
- ↑ <"https://commons.wikimedia.org/wiki/File%3AGastric_Varices.jpg">via Wikimedia Commons
- ↑ "(A) Angiographic portography revealed portal vein, coro | Open-i".
- ↑ Radiopaedia.org. From the case <"https://radiopaedia.org/cases/16761">rID: 16761
- ↑ Abby Philips C, Sahney A (2016). "Oesophageal and gastric varices: historical aspects, classification and grading: everything in one place". Gastroenterol Rep (Oxf). 4 (3): 186–95. doi:10.1093/gastro/gow018. PMC 4976684. PMID 27324725.
- ↑ Thakeb F, Salem SA, Abdallah M, el Batanouny M (1994). "Endoscopic diagnosis of gastric varices". Endoscopy. 26 (3): 287–91. doi:10.1055/s-2007-1008969. PMID 8076547.
- ↑ Agarwal A, Jain M (2008). "Multidetector CT portal venography in evaluation of portosystemic collateral vessels". J Med Imaging Radiat Oncol. 52 (1): 4–9. doi:10.1111/j.1440-1673.2007.01903.x. PMID 18373819.
- ↑ Kang HK, Jeong YY, Choi JH, Choi S, Chung TW, Seo JJ; et al. (2002). "Three-dimensional multi-detector row CT portal venography in the evaluation of portosystemic collateral vessels in liver cirrhosis". Radiographics. 22 (5): 1053–61. doi:10.1148/radiographics.22.5.g02se011053. PMID 12235335.