| Theme |
Present Status and Future Aspects of EUS |
| Title |
EUS in Diagnosis of Esophago-Gastric Varices |
| Author |
Shinichi Nakamura |
Institute of Gastroenterology, Tokyo Women's Medical University |
| Author |
Yoko Murata |
Institute of Gastroenterology, Tokyo Women's Medical University / Murata Clinic |
| Author |
Atsushi Mitsunaga |
Institute of Gastroenterology, Tokyo Women's Medical University |
| Author |
Itaru Oi |
Institute of Gastroenterology, Tokyo Women's Medical University |
| Author |
Keiko Shiratori |
Institute of Gastroenterology, Tokyo Women's Medical University |
| [ Summary ] |
At the present time, both ligation and sclerotherapy are widely performed as endoscopic treatments for esophago-gastric varices. It is necessary for rational treatment to understand variceal hemodynamics before initiation. It is impossible to clearly visualize the relationship of regional vascular systems inside and outside the esophageal wall from the cardia of the stomach to the distal esophagus with conventional endoscopy. In this respect, endoscopic ultrasonography (EUS) is a useful method for performing evaluation, both before and after treatment, since it is capable of clearly depicting the relationship between esophageal varices and the vascular systems outside of the esophageal wall and is noninvasive. Recently, some types of EUS apparatus with color Doppler systems and three dimensional image processing systems have been developed for clinical use. The relationship between esophageal varices and their feeding vessels, paraesophageal veins, or perforating vessels can be easily understood, facilitating the assessment of hemodynamics. We observed the vascular patterns of esophageal varices using three dimensional-EUS (3D-EUS). The vascular patterns of esophageal varices, classified by 3D-EUS, enabled us to clarify the criteria for making a choice of endoscopic procedures. Furthermore, EUS combined with CT gives us more information concerning therapeutic strategies and predictions of variceal recurrence. |