Risk of esophageal variceal bleeding based on endoscopic ultrasound evaluation of the sum of esophageal variceal cross-sectional surface area

• DOI: 10.1111/j.1572-0241.2003.07224.x
• Publication Date: 2004-03-23T14:20:43Z
• Authors: Larry Miller; Felice L. Banson; Khalid Bazir; Anapurna Korimilli; J.i-Bin Liu; Richa Dewan; Michael Wolfson; Kashyap V. Pangan...; Jose Carrasquillo; Jonathan Schwartz; Albert E. Chaker; Martin Black
• Keywords: Bleed; Endoscopic Ultrasound; Esophageal disease

The aim of this study was to evaluate the risk future variceal bleeding, based on endoscopic ultrasound measurement sum cross-sectional surface area (CSA) all esophageal varices in distal esophagus.Twenty-eight patients with portal hypertension and varices, but no prior history were evaluated using (20-MHz probe, Microvasive, Boston, MA; Olympus, Tokyo, Japan). entire esophagus imaged, an image selected at a point where appeared largest. This digitized, CSA measured (Image Pro Plus, Silver Springs, MD) by investigator blinded patients' clinical status. follow-up time for each patient calculated (time first bleed, liver transplantation, death, or end study). Cox Proportional Hazards Model used determine if there significant difference between sums who bled compared those did not bleed. An OR bleeding as cm(2)/month. Positive negative predictive values bleeding.Six 28 (21%) experienced follow-up. mean +/- SEM these 0.77 cm(2) 0.31 (range 0.07-2.09 cm(2)). 15.5 months 4.95 1-29 months). Twenty-two (79%) experience bleeding. 0.36 0.08 0.02-1.19 35.7 6.69 1.2-103.2 bleed significantly different p < 0.018 level. one per month 6.34. Using cutoff 0.45 cm(2), sensitivity specificity 83% 75%, respectively.There is (p 0.018) will not. There 76-fold increase year CSA. value above below respectively.