Endoscopic diagnosis and therapy of duodenal varices

Abstract

Objective To evaluat the endoscopic diagnosis and treatment of duodenal varices. Meth- ods Twenty-six cases of duodenal varices detected by endoscopy from a total of 93 283 patients from Novem- ber 2000 to August 2008, were classified according to the location, diameter and risk factor （LDRf） of the varices. The patients were treated according to the classification and followed. Results The duodenal varices were classified as Ld1 （5, 19.2% ）, Ld1.2 （2, 7.7% ） and Ld2 （ 19, 73.1% ） ; DO （0）, D0.3 （2）, D1 （10）, D2 （ 13 ） and D3 （ 1 ） ; Rf0 （23）, Rf1 （0） and Rf2 （ 3 ）. Of 26 patients, 18 were accompanied with esophageal and （or） gastric fundic varicosis. Hepatitis B-related cirrhosis occurred in 9 of 17 hospitalized cases, of which 3 cases of Rf2 were treated with endoscopic procedures. Histoacry injection was performed in 1 patient of Ld2D3Rf2 to stop active bleeding and in another patient of Ld2D2Rf2, endoscopic ligation was performed in 1 case of Ld2Dl Rf2. The patients were followed up for 14. 6 months on average. Duodenal varicosis in 3 patients vanished in 1.0-3.5 months after the treatment, and there was no recurrence. Of those patients who did not re- ceive endoscopic treatment, 11 were followed up, and no varices bleeding was found. Two patients died of other reasons. Conclusion LDRf classification can reflect endoscopic features of duodenal varicosis, and it is safe and feasible to choose therapy according to LDRf classification. Key words: Duodenum ; Varices ; Endoscopy ; Classification ; Therapies,investigational