Clinical Endoscopy

Endoscopic Therapy and Radiologic Intervention of Acute Gastroesophageal Variceal Bleeding: Jeong Eun Song, Byung Seok Kim; Clin Endosc 2019;52(5):407-415. Published online September 30, 2019; DOI: https://doi.org/10.5946/ce.2019.178

Acute gastroesophageal variceal hemorrhage is a dreaded complication in patients with liver cirrhosis. Endoscopic therapy and radiologic intervention for gastroesophageal bleeding have rapidly developed in the recent decades. Endoscopic treatment is initially performed to stop variceal hemorrhage. For the treatment of esophageal variceal bleeding, endoscopic variceal ligation (EVL) is considered the endoscopic treatment of choice. In cases of gastric variceal hemorrhage, the type of gastric varices (GVs) is important in deciding the strategy of endoscopic treatment. Endoscopic variceal obturation (EVO) is recommended for fundal variceal bleeding. For the management of gastroesophageal varix type 1 bleeding, both EVO and EVL are available treatment options; however, EVO is preferred over EVL. If endoscopic management fails to control variceal hemorrhage, radiologic interventional modalities could be considered. Transjugular intrahepatic portosystemic shunt is a good option for rescue treatment in refractory variceal bleeding. In cases of refractory hemorrhage of GVs in patients with a gastrorenal shunt, balloon-occluded retrograde transvenous obliteration could be considered as a salvage treatment.

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Transjugular intrahepatic portosystemic shunt for esophagojejunal variceal bleeding after total gastrectomy: A case report
Sang Un Kim, Jihoon Hong
Radiology Case Reports.2024; 19(8): 3231. CrossRef
Efficacy of early re-ligation after endoscopic gastric glue injection combined with endoscopic variceal ligation in preventing rebleeding of esophagogastric varices in patients with cirrhosis
Hui-Min Liu, Zhi-Bin Gong
World Chinese Journal of Digestology.2022; 30(17): 748. CrossRef
The Role of Interventional Radiology in Esophageal Varices and Hematemesis: Review Article
Qaed Salem Alhammami, Maisa Hamad Freaj Alanazi, Shahad Khalid A Bedaiwi, Ghazir Aneed N Alruwili, Shouq Fayed Khalaf Alanazi
Archives of Pharmacy Practice.2022; 13(4): 7. CrossRef
Comprehensive treatment of patients with gastric variceal bleeding
S.M. Chooklin, S.S. Chuklin
EMERGENCY MEDICINE.2022; 18(8): 14. CrossRef

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Endoscopic Ultrasound-Guided Vascular Therapy: The Present and the Future: Philip S.J. Hall, Christopher Teshima, Gary R. May, Jeffrey D. Mosko; Clin Endosc 2017;50(2):138-142. Published online March 30, 2017; DOI: https://doi.org/10.5946/ce.2017.048

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Endoscopic ultrasound (EUS) offers access to many intra-abdominal vessels that until now have only been accessible to the surgeon and interventional radiologist. In addition to assisting with diagnostics, this unique access offers the potential for therapeutic intervention for a host of indications. To date, this has had the most clinical impact in the treatment of gastroesophageal varices, with EUS-guided coil and glue application growing in use worldwide. Although randomised controlled trial data is lacking, we discuss the growing body of literature behind EUS-guided therapy in the management of varices. EUS has also been used in specialized centres to assist in non-variceal gastrointestinal bleeding. The treatment of bleeding from Dieulafoy lesions, tumours and pancreatic pseudoaneurysms has all been described. The potential applications of EUS have also extended to the placement of portal vein stents and porto-systemic shunts in animal models. As medicine continues to move to increasingly less invasive interventions, EUS-guided therapies offer substantial promise for the safe and effective delivery of targeted treatment for a widening array of vascular disorders.

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EUS-guided cyanoacrylate injection into the perforating vein versus direct endoscopic injection in the treatment of gastric varices
Fady Sabry, Seham Seif, Ayman Eldesoky, Hazem Hakim, Ahmed Youssef Altonbary
Endoscopy International Open.2023; 11(02): E202. CrossRef
Endoscopic diagnosis of gastrointestinal melanoma
Sheng Wang, Siyu Sun, Xiang Liu, Nan Ge, Guoxin Wang, Jintao Guo, Wen Liu, Jinlong Hu
Scandinavian Journal of Gastroenterology.2020; 55(3): 330. CrossRef
Endoscopic Ultrasound-Guided Treatments for Non-Variceal Upper GI Bleeding: A Review of the Literature
Claudio Giovanni De Angelis, Pablo Cortegoso Valdivia, Stefano Rizza, Ludovica Venezia, Felice Rizzi, Marcantonio Gesualdo, Giorgio Maria Saracco, Rinaldo Pellicano
Journal of Clinical Medicine.2020; 9(3): 866. CrossRef
RECOMMENDATIONS FOR INVASIVE PROCEDURES IN PATIENTS WITH DISEASES OF THE LIVER AND BILIARY TRACT: REPORT OF A JOINT MEETING OF THE BRAZILIAN SOCIETY OF HEPATOLOGY (SBH), BRAZILIAN SOCIETY OF DIGESTIVE ENDOSCOPY (SOBED) AND BRAZILIAN SOCIETY OF INTERVENTIO
Leonardo de Lucca SCHIAVON, Flávio Hayato EJIMA, Marcos Roberto de MENEZES, Paulo Lisboa BITTENCOURT, Aírton Mota MOREIRA, Alberto Queiroz FARIAS, Aline Lopes CHAGAS, André Moreira de ASSIS, Ângelo Zambam de MATTOS, Bruno Chaves SALOMÃO, Carlos TERRA, Fer
Arquivos de Gastroenterologia.2019; 56(2): 213. CrossRef
Endoscopic Therapy for Variceal Bleeding: from Patient Preparation to Available Techniques and Rescue Therapies
Philippe Sultanik, Dominique Thabut
Current Hepatology Reports.2017; 16(4): 398. CrossRef
Role of combined propofol and sufentanil anesthesia in endoscopic injection sclerotherapy for esophageal varices
Yang Yu, Sheng-Lin Qi, Yong Zhang
World Journal of Gastroenterology.2017; 23(44): 7875. CrossRef

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Usefulness of Endoscopic Ultrasound in Esophagogastric Varices: Jae-Jun Shim; Clin Endosc 2012;45(3):324-327. Published online August 22, 2012; DOI: https://doi.org/10.5946/ce.2012.45.3.324

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Endoscopic ultrasound (EUS) is a useful diagnostic tool for evaluation of esophagogastric varices and guidance of endoscopic therapy. EUS can visualize not only collateral veins around the esophagus but also perforating veins that connect esophageal varices with collateral veins. They are associated with high risk of bleeding and early recurrence after initial variceal eradication. Isolated gastric varices can be easily diagnosed using EUS that mimic thickened gastric folds or subepithelial tumors. EUS-guided endoscopic therapy is a challenging field of variceal bleeding. It has a potential role for assistance of interventions and evaluation of treatment outcome.

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Study Advances in Diagnosis and Treatment of Esophageal Collateral Varices in Cirrhosis
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Advances in Clinical Medicine.2024; 14(04): 372. CrossRef
Role of Endoscopic Ultrasound in Liver Disease: Where Do We Stand?
Tajana Pavic, Ivana Mikolasevic, Dominik Kralj, Nina Blazevic, Anita Skrtic, Ivan Budimir, Ivan Lerotic, Davor Hrabar
Diagnostics.2021; 11(11): 2021. CrossRef
Role of endoscopic ultrasound in liver disease: Where do we stand in 2017?
Hamzeh A Saraireh, Mohammad Bilal, Shailendra Singh
World Journal of Hepatology.2017; 9(24): 1013. CrossRef
Role of combined propofol and sufentanil anesthesia in endoscopic injection sclerotherapy for esophageal varices
Yang Yu, Sheng-Lin Qi, Yong Zhang
World Journal of Gastroenterology.2017; 23(44): 7875. CrossRef

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Successful Treatment of Early Gastric Cancer Adjacent to a Fundal Varix by Endoscopic Submucosal Dissection and Endoscopic Cyanoacrylate Therapy: Yeon Soo Kim, Won Young Cho, Joo Young Cho, So Young Jin; Clin Endosc 2012;45(2):169-173. Published online June 30, 2012; DOI: https://doi.org/10.5946/ce.2012.45.2.169

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Endoscopic submucosal dissection (ESD) was developed for the en bloc resection of large early gastrointestinal neoplasms. A disadvantage of ESD is its technical difficulty, which requires advanced skills and is associated with a higher rate of complications. Endoscopic variceal obturation (EVO) using cyanoacrylate has emerged as the initial treatment of choice for acute gastric variceal bleeding. This procedure achieves hemostasis in 90% of cases. A 52-year-old patient with Child A alcoholic liver cirrhosis presented with early gastric cancer in the cardia and type 1 isolated gastric varices in the fundus. The two lesions were so close together that treatment was not easy. The lesions were managed successfully with a combination of ESD and EVO using cyanoacrylate.

Citations

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Successful endoscopic submucosal dissection for early gastric cancer adjacent to gastric cardia varix
Ko Watanabe, Takuto Hikichi, Jun Nakamura, Tadayuki Takagi, Rei Suzuki, Mitsuru Sugimoto, Yuichi Waragai, Hitomi Kikuchi, Naoki Konno, Hiroyuki Asama, Mika Takasumi, Hiroshi Watanabe, Katsutoshi Obara, Hiromasa Ohira
FUKUSHIMA JOURNAL OF MEDICAL SCIENCE.2016; 62(2): 101. CrossRef
Injection and Cautery Methods for Nonvariceal Bleeding Control
Cristina Bucci, Gianluca Rotondano, Riccardo Marmo
Gastrointestinal Endoscopy Clinics of North America.2015; 25(3): 509. CrossRef
Hyaluronic acid solution injection for upper and lower gastrointestinal bleeding after failed conventional endoscopic therapy
Jin Wook Lee, Hyung Hun Kim
Digestive Endoscopy.2014; 26(2): 285. CrossRef
Observable Laryngopharyngeal Lesions during the Upper Gastrointestinal Endoscopy
Kyung Sik Park
Clinical Endoscopy.2013; 46(3): 224. CrossRef

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