The role of endoscopic ultrasonography for esophagogastric varices

Abstract

In patients with esophageal varices accompanied by complicating portal hypertension, a large network of portal-systemic collateral veins develops. Endoscopic ultrasonography (EUS), especially ultrasound mini-probe, allows for noninvasive imaging of collateral circulation in the esophagus as well as the inside and outside of the gastric wall and allows treatment selection tailored to the hemodynamics of each individual varix. The characteristics to be evaluated in a patient with esophagogastric varices with EUS include the following: (1) diameter of the varix, (2) perforating veins, (3) periesophageal veins/perigastric veins, and (4) paraesophageal veins/paragastric veins. The observation of these structures provides important information for safer and more effective treatments; in addition, EUS also provides information that is useful for the prediction of recurrence.