Gastrointestinal varices classification: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Gastrointestinal varices}} | {{Gastrointestinal varices}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}} {{HK}} | ||
==Overview== | ==Overview== | ||
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{| class="wikitable" | {| class="wikitable" | ||
! | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Classification system | ||
! | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Grade | ||
! | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Interpretation of grade | ||
|- | |- | ||
| rowspan="5" |'''Dagradi classification''' | | rowspan="5" |'''Dagradi classification''' | ||
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The following table outlines the major classification systems adapted for classifying gastric varices:<ref name="pmid2340395">{{cite journal |vauthors=Mathur SK, Dalvi AN, Someshwar V, Supe AN, Ramakantan R |title=Endoscopic and radiological appraisal of gastric varices |journal=Br J Surg |volume=77 |issue=4 |pages=432–5 |year=1990 |pmid=2340395 |doi= |url=}}</ref><ref name="pmid3349325">{{cite journal |vauthors=Hosking SW, Johnson AG |title=Gastric varices: a proposed classification leading to management |journal=Br J Surg |volume=75 |issue=3 |pages=195–6 |year=1988 |pmid=3349325 |doi= |url=}}</ref><ref name="pmid2365213">{{cite journal |vauthors=Hashizume M, Kitano S, Yamaga H, Koyanagi N, Sugimachi K |title=Endoscopic classification of gastric varices |journal=Gastrointest. Endosc. |volume=36 |issue=3 |pages=276–80 |year=1990 |pmid=2365213 |doi= |url=}}</ref><ref name="pmid1446890">{{cite journal |vauthors=Sarin SK, Lahoti D, Saxena SP, Murthy NS, Makwana UK |title=Prevalence, classification and natural history of gastric varices: a long-term follow-up study in 568 portal hypertension patients |journal=Hepatology |volume=16 |issue=6 |pages=1343–9 |year=1992 |pmid=1446890 |doi= |url=}}</ref><ref name="pmid11928080">{{cite journal |vauthors=Arakawa M, Masuzaki T, Okuda K |title=Pathomorphology of esophageal and gastric varices |journal=Semin. Liver Dis. |volume=22 |issue=1 |pages=73–82 |year=2002 |pmid=11928080 |doi=10.1055/s-2002-23208 |url=}}</ref><ref name="pmid11323583">{{cite journal |vauthors=Iwase H, Maeda O, Shimada M, Tsuzuki T, Peek RM, Nishio Y, Ando T, Ina K, Kusugami K |title=Endoscopic ablation with cyanoacrylate glue for isolated gastric variceal bleeding |journal=Gastrointest. Endosc. |volume=53 |issue=6 |pages=585–92 |year=2001 |pmid=11323583 |doi= |url=}}</ref> | The following table outlines the major classification systems adapted for classifying gastric varices:<ref name="pmid2340395">{{cite journal |vauthors=Mathur SK, Dalvi AN, Someshwar V, Supe AN, Ramakantan R |title=Endoscopic and radiological appraisal of gastric varices |journal=Br J Surg |volume=77 |issue=4 |pages=432–5 |year=1990 |pmid=2340395 |doi= |url=}}</ref><ref name="pmid3349325">{{cite journal |vauthors=Hosking SW, Johnson AG |title=Gastric varices: a proposed classification leading to management |journal=Br J Surg |volume=75 |issue=3 |pages=195–6 |year=1988 |pmid=3349325 |doi= |url=}}</ref><ref name="pmid2365213">{{cite journal |vauthors=Hashizume M, Kitano S, Yamaga H, Koyanagi N, Sugimachi K |title=Endoscopic classification of gastric varices |journal=Gastrointest. Endosc. |volume=36 |issue=3 |pages=276–80 |year=1990 |pmid=2365213 |doi= |url=}}</ref><ref name="pmid1446890">{{cite journal |vauthors=Sarin SK, Lahoti D, Saxena SP, Murthy NS, Makwana UK |title=Prevalence, classification and natural history of gastric varices: a long-term follow-up study in 568 portal hypertension patients |journal=Hepatology |volume=16 |issue=6 |pages=1343–9 |year=1992 |pmid=1446890 |doi= |url=}}</ref><ref name="pmid11928080">{{cite journal |vauthors=Arakawa M, Masuzaki T, Okuda K |title=Pathomorphology of esophageal and gastric varices |journal=Semin. Liver Dis. |volume=22 |issue=1 |pages=73–82 |year=2002 |pmid=11928080 |doi=10.1055/s-2002-23208 |url=}}</ref><ref name="pmid11323583">{{cite journal |vauthors=Iwase H, Maeda O, Shimada M, Tsuzuki T, Peek RM, Nishio Y, Ando T, Ina K, Kusugami K |title=Endoscopic ablation with cyanoacrylate glue for isolated gastric variceal bleeding |journal=Gastrointest. Endosc. |volume=53 |issue=6 |pages=585–92 |year=2001 |pmid=11323583 |doi= |url=}}</ref> | ||
{| class="wikitable" | {| class="wikitable" | ||
! | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Classification system | ||
! | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Grade | ||
! | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Interpretation of grade | ||
|- | |- | ||
|Hoskins and Johnson’s classification | | rowspan="3" |Hoskins and Johnson’s classification | ||
|1 | |1 | ||
| | | | ||
* Extension of esophageal varices across the [[Squamous epithelium|squamo]]-[[Columnar epithelia|columnar]] junction | * Extension of esophageal varices across the [[Squamous epithelium|squamo]]-[[Columnar epithelia|columnar]] junction | ||
|- | |- | ||
|2 | |2 | ||
| | | | ||
| Line 161: | Line 160: | ||
* Overlap with esophageal varices in the [[esophagus]] at cardiac end | * Overlap with esophageal varices in the [[esophagus]] at cardiac end | ||
|- | |- | ||
|3 | |3 | ||
| | | | ||
| Line 167: | Line 165: | ||
* No esophageal varices | * No esophageal varices | ||
|- | |- | ||
|Mathur’s classification | | rowspan="5" |Mathur’s classification | ||
|1 | |1 | ||
| | | | ||
* Esophageal varices with [[Lesser curvature of the stomach|lesser curvature]] varices | * Esophageal varices with [[Lesser curvature of the stomach|lesser curvature]] varices | ||
|- | |- | ||
|2 | |2 | ||
| | | | ||
| Line 179: | Line 176: | ||
* 2b – Diffuse fundal | * 2b – Diffuse fundal | ||
|- | |- | ||
|3 | |3 | ||
| | | | ||
| Line 186: | Line 182: | ||
* 3b – Secondary to generalized [[portal hypertension]] | * 3b – Secondary to generalized [[portal hypertension]] | ||
|- | |- | ||
|4 | |4 | ||
| | | | ||
| Line 192: | Line 187: | ||
* Esophageal varices along with varices located in the [[Fundus (stomach)|gastric fundus]] | * Esophageal varices along with varices located in the [[Fundus (stomach)|gastric fundus]] | ||
|- | |- | ||
|5 | |5 | ||
| | | | ||
* Varices in the [[Antrum|gastric antrum]] | * Varices in the [[Antrum|gastric antrum]] | ||
|- | |- | ||
|Hashizume’s classification | | rowspan="3" |Hashizume’s classification | ||
|Form | |Form | ||
| | | | ||
| Line 205: | Line 199: | ||
** F3: Tumorous | ** F3: Tumorous | ||
|- | |- | ||
|Location | |Location | ||
| | | | ||
| Line 215: | Line 208: | ||
** Lf: [[Fundus (stomach)|Fundic areas of the stomach]] | ** Lf: [[Fundus (stomach)|Fundic areas of the stomach]] | ||
|- | |- | ||
|Color | |Color | ||
| | | | ||
| Line 223: | Line 215: | ||
** RCS: Thin-walled focal redness on the varix as red colored spot | ** RCS: Thin-walled focal redness on the varix as red colored spot | ||
|- | |- | ||
|Sarin’s classification | | rowspan="4" |Sarin’s classification | ||
|Gastro-esophageal type 1 | |Gastro-esophageal type 1 | ||
| | | | ||
* Esophageal varices spreading into the [[lesser curvature of the stomach]] | * Esophageal varices spreading into the [[lesser curvature of the stomach]] | ||
|- | |- | ||
|Gastro-esophageal type 2 | |Gastro-esophageal type 2 | ||
| | | | ||
* Esophageal varices spreading into the [[greater curvature of the stomach]] | * Esophageal varices spreading into the [[greater curvature of the stomach]] | ||
|- | |- | ||
|Isolated gastric type 1 | |Isolated gastric type 1 | ||
| | | | ||
* Varices in the [[Fundus (stomach)|gastric fundus]] and [[cardia]] without esophageal varices | * Varices in the [[Fundus (stomach)|gastric fundus]] and [[cardia]] without esophageal varices | ||
|- | |- | ||
|Isolated gastric type 2 | |Isolated gastric type 2 | ||
| | | | ||
Latest revision as of 13:56, 24 January 2018
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Gastrointestinal varices Microchapters |
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Differentiating Gastrointestinal varices from other Diseases |
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Gastrointestinal varices classification On the Web |
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American Roentgen Ray Society Images of Gastrointestinal varices classification |
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Risk calculators and risk factors for Gastrointestinal varices classification |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]
Overview
Gastrointestinal varices may be further classified into esophageal and gastric varices. Esophageal varices may be further divided according to various classification systems such as the Dagradi classification, Conn's classification, Pachquet classification, Westaby classification, Soehendra classification and Cales classification. Gastric varices may be classified according to Hoskins and Johnson’s classification, Mathur’s classification, Hashizume classification and Sarin's classification system. These classificatication systems are based on morphological features, anatomical location, size and color of the varices.
Classification
Classification of esophageal varices
The following table outlines the major classification schemes for esophageal varices, based on grades, taking into account morphological features, size and anatomical location:[1][2][3][4][5][6][7][8][9][10][11][12][13]
| Classification system | Grade | Interpretation of grade |
|---|---|---|
| Dagradi classification | 1 |
|
| 2 |
| |
| 3 | ||
| 4 |
| |
| 5 |
| |
| Conn's classification | I |
|
| II |
| |
| III |
| |
| IV |
| |
| Paquet’s classification | I |
|
| II | ||
| III |
| |
| IV |
| |
| Westaby classification | 1 |
|
| 2 |
| |
| 3 |
| |
| Soehendra classification | I |
|
| II | ||
| III | ||
| IV |
| |
| Calès classification | 1 |
|
| 2 |
| |
| 3 |
|
Classification of gastric varices
The following table outlines the major classification systems adapted for classifying gastric varices:[14][15][16][17][18][19]
| Classification system | Grade | Interpretation of grade |
|---|---|---|
| Hoskins and Johnson’s classification | 1 | |
| 2 |
| |
| 3 |
| |
| Mathur’s classification | 1 |
|
| 2 |
| |
| 3 |
| |
| 4 |
| |
| 5 |
| |
| Hashizume’s classification | Form |
|
| Location |
| |
| Color |
| |
| Sarin’s classification | Gastro-esophageal type 1 |
|
| Gastro-esophageal type 2 |
| |
| Isolated gastric type 1 |
| |
| Isolated gastric type 2 |
References
- ↑ BUTLER H (1951). "The veins of the oesophagus". Thorax. 6 (3): 276–96. PMC 1018380. PMID 14884140.
- ↑ Sternlieb I, Scheinberg IH, Walshe JM (1970). "Bleeding oesophageal varices in patients with Wilson's disease". Lancet. 1 (7648): 638–41. PMID 4190630.
- ↑ BRICK IB, PALMER ED (1964). "ONE THOUSAND CASES OF PORTAL CIRRHOSIS OF THE LIVER. IMPLICATIONS OF ESOPHAGEAL VARICES AND THEIR MANAGEMENT". Arch. Intern. Med. 113: 501–11. PMID 14109008.
- ↑ Dagradi AE, Stempien SJ, Owens LK (1966). "Bleeding esophagogastric varices. An endoscopic study of 50 cases". Arch Surg. 92 (6): 944–7. PMID 5295832.
- ↑ Conn HO (1967). "Ammonia tolerance in the diagnosis of esophageal varices. A comparison of endoscopic, radiologic, and biochemical techniques". J. Lab. Clin. Med. 70 (3): 442–51. PMID 6066657.
- ↑ "The general rules for recording endoscopic findings on esophageal varices". Jpn J Surg. 10 (1): 84–7. 1980. PMID 7373958.
- ↑ Beppu K, Inokuchi K, Koyanagi N, Nakayama S, Sakata H, Kitano S, Kobayashi M (1981). "Prediction of variceal hemorrhage by esophageal endoscopy". Gastrointest. Endosc. 27 (4): 213–8. PMID 6975734.
- ↑ Westaby D, Macdougall BR, Melia W, Theodossi A, Williams R (1983). "A prospective randomized study of two sclerotherapy techniques for esophageal varices". Hepatology. 3 (5): 681–4. PMID 6352448.
- ↑ "Prediction of the first variceal hemorrhage in patients with cirrhosis of the liver and esophageal varices. A prospective multicenter study". N. Engl. J. Med. 319 (15): 983–9. 1988. doi:10.1056/NEJM198810133191505. PMID 3262200.
- ↑ "Reliability of endoscopy in the assessment of variceal features. The Italian Liver Cirrhosis Project". J. Hepatol. 4 (1): 93–8. 1987. PMID 3494762.
- ↑ Calès P, Zabotto B, Meskens C, Caucanas JP, Vinel JP, Desmorat H, Fermanian J, Pascal JP (1990). "Gastroesophageal endoscopic features in cirrhosis. Observer variability, interassociations, and relationship to hepatic dysfunction". Gastroenterology. 98 (1): 156–62. PMID 2293575.
- ↑ de Franchis R (2015). "Expanding consensus in portal hypertension: Report of the Baveno VI Consensus Workshop: Stratifying risk and individualizing care for portal hypertension". J. Hepatol. 63 (3): 743–52. doi:10.1016/j.jhep.2015.05.022. PMID 26047908.
- ↑ Zoli M, Merkel C, Magalotti D, Marchesini G, Gatta A, Pisi E (1996). "Evaluation of a new endoscopic index to predict first bleeding from the upper gastrointestinal tract in patients with cirrhosis". Hepatology. 24 (5): 1047–52. doi:10.1053/jhep.1996.v24.pm0008903373. PMID 8903373.
- ↑ Mathur SK, Dalvi AN, Someshwar V, Supe AN, Ramakantan R (1990). "Endoscopic and radiological appraisal of gastric varices". Br J Surg. 77 (4): 432–5. PMID 2340395.
- ↑ Hosking SW, Johnson AG (1988). "Gastric varices: a proposed classification leading to management". Br J Surg. 75 (3): 195–6. PMID 3349325.
- ↑ Hashizume M, Kitano S, Yamaga H, Koyanagi N, Sugimachi K (1990). "Endoscopic classification of gastric varices". Gastrointest. Endosc. 36 (3): 276–80. PMID 2365213.
- ↑ Sarin SK, Lahoti D, Saxena SP, Murthy NS, Makwana UK (1992). "Prevalence, classification and natural history of gastric varices: a long-term follow-up study in 568 portal hypertension patients". Hepatology. 16 (6): 1343–9. PMID 1446890.
- ↑ Arakawa M, Masuzaki T, Okuda K (2002). "Pathomorphology of esophageal and gastric varices". Semin. Liver Dis. 22 (1): 73–82. doi:10.1055/s-2002-23208. PMID 11928080.
- ↑ Iwase H, Maeda O, Shimada M, Tsuzuki T, Peek RM, Nishio Y, Ando T, Ina K, Kusugami K (2001). "Endoscopic ablation with cyanoacrylate glue for isolated gastric variceal bleeding". Gastrointest. Endosc. 53 (6): 585–92. PMID 11323583.