Perforating veins - a parameter of recurrence of esophageal varices.

OBJECTIVE

To study the role of perforating veins in predicting the likelihood of esophageal variceal rupture and variceal recurrences.

METHODS

In 70 patients with esophageal varices, a 20 MHz ultrasonographic transducer was used to image esophageal varices; the radius and perforating veins were calculated. Esophageal variceal pressure measurements were obtained by noninvasive pressure gauge. The relationship between the size of esophageal varices and the presence of perforating veins in the esophageal wall was studied using chi-square test; the patients were divided into two groups according to the presence of perforating veins, and the pressure in each group was compared by using Student's t test. In addition, the frequency of endoscopy sessions necessary for varix eradication, the dots of endoscopic variceal ligation and recurrence of esophageal varices within a year were also compared by the Mann-Whitney U test.

RESULTS

The presence of perforating veins in the esophageal wall was significantly higher in patients with large radius of varices than in patients with small radius. The esophageal variceal pressure in patients with perforating veins was greater than that of patients without perforating veins (23+/- 4.5 vs 12+/-3.1 mmHg, p<0.05). The frequency of endoscopy sessions required for varix eradication and the dots of EVL in patients with perforating veins was greater than that in patients without perforating veins (3.25 +/- 0.50 vs. 2.11+/-.78; 25 +/-.50 vs. 18.56+/- 5.46 p<0.05). The recurrence of esophageal varices within a year was higher in patients with than in patients without perforating veins (75.93 vs. 18.75%, p<0.05).

CONCLUSION

Perforating veins in the esophageal wall correlate with the recurrence of esophageal varices in patients with portal hypertension