ENDOSCOPIC ULTRASONOGRAPHY FINDINGS AND CLINICAL BACKGROUNDS IN CASES WITH EARLY RECURRENCE OF ESOPHAGEAL VARICES AFTER ENDOSCOPIC INJECTION SCLEROTHERAPY

Abstract

Aims: To investigate the factors affecting early recurrence of esophageal varices after endoscopic injection sclerotherapy (EIS).Subjects and Methods: Forty‐four cases with esophageal varices were examined by esophagogastroscopy and endoscopic ultrasonography (EUS) 2 months after EIS. Cases with and without red color (RC) signs evaluated within 1 year after EIS were classified as Early Recurrent Group (ERG) and Non‐Early Recurrent Group (N‐ERG), respectively, and compared with EUS images and clinical backgrounds.Results: Compared with ERG (17 cases), N‐ERG (27 cases) had significantly higher detection rates of cardiac intramural veins (CV) and esophageal intramural veins (EV), larger maximum diameters of CV and EV, and higher numbers of CV (P < 0.05). The detection rates of gastric perforating veins (GPV)—but not esophageal perforating veins (EPV), paragastric veins (PGV), or paraesophageal veins (PEV)—correlated with recurrence of varices (P < 0.05). ERG differed in age, gender, γ‐glutamyltranspeptidase (GTP), and detection rates of portosystemic (PS) shunts from N‐ERG (P < 0.05). Age, serum alanine aminotransferase (ALT) and γ‐GTP level, detection rates of PS shunt, maximum diameters of CV and EV, numbers of CV, and GPV‐positive case differed (P < 0.10) by univariate analysis, and maximum diameters (hazard ratio (HR)), 7.16: 95% CI [1.45–35.33]; P = 0.016) and numbers (HR, 1.96: 95% CI, [1.02–3.75]; P = 0.043) of CV differed significantly between the two groups by multivariate analysis.Conclusions: EUS is useful in predicting recurrence of esophageal varices after EIS, and the degree of the development of CV is the most important critical factor for early recurrences.