The etiology and clinical features of isolated gastric varices / 中华消化杂志

ABSTRACT

Objective To analyze the etiology and clinical features of isolated gastric varices.Methods A retrospectives analysis was carried out in 31 patients with isolated gastric varices between January 2003 and January 2008.The patients records including data of etiology,clinical presentation,imaging studies and therapeutic modalities were reviewed.Results Those who had isolated gastric varices were accounted for 7.38 0A (31/420)of all patients with gastroesophageal varices.The etiologies were left-sided portal hypertension(14 cases,45.2%),liver cirrhosis(8 cases,25.8%),unknown origin(6 eases,19.4%),hepatocellular carcinoma(2 cases,6.5%),portal cavernous transformation(1 case,3.2%).Twenty-one patients(67.7%)had variceal hemorrhage.Splenomegaly was present in 21 cases(67.7%),among which 10 cases(32.3%)had concomitant hypersplenism.Venous involvement was identified in 18 patients(splenic vein obstruction in 9 cases and portal vein involvement in 9 cases).Surgical therapy was performed in 8 cases,selerotherapy in 3 cases,and medical therapy in 20 cases.Conclusions Left-side portal hypertension is responsible for most of the isolated gastric varices,and some of which are also caused by liver cirrhosis.Surgery is the appropriate procedure of choice in management of hemorrhage and recurrence.