ENDOSCOPIC DIAGNOSIS OF GASTRIC VARICES

In this retrospective study, the presence and appearance of gastric va rices were analyzed among patients presenting at Kasr El Aini Hospital with variceal bleeding during the period from 1984 to 1989. Two group s of patients were studied. The first group included 970 patients with documented variceal bleeding with no history of sclerotherapy. Of the se patients 6.7 %, had concomitant gastric varices, and 27.1 % had dir ect gastric extension of esophageal varices (mostly of grade 3). Gastr ic varices alone, without esophageal varices, were found in five cases (0.5 %). The second group was a subgroup, and included 376 patients w ho underwent complete sclerotherapeutic eradication of varices restric ted to the esophagus and were without gastric varices at the first pre sentation. Eleven of these patients (2.9 %) developed secondary gastri c varices. There was no correlation between the risk of bleeding from primary gastric varices (seen at the first presentation) and the grade of the esophageal varices. There were more bleeding episodes from lar ge gastric varices (35.4 % for the cauliflower and 16.9 % for the cyst ic forms) than from the small varices, i.e. ruga-like and network-like gastric varices. The study also shows that the secondary development of gastric varices after endoscopic variceal sclerotherapy is a rare e vent, and that there was no risk of bleeding from the secondary gastri c varices. Patients with esophageal varices with gastric extension had a small risk of bleeding from their gastric varices (5.2 %),