Clinical analysis of the relationship between hemorrhage and position of stigmata in patients with esophageal varices / 中华消化内镜杂志

ABSTRACT

Objective To investigate the predisposing locations of active hemorrhage in patients with esophageal variceal bleeding. Methods Data of 823 patients with acute esophageal and gastric variceal hemorrhage receiving emergency gastroscopy diagnosed from January 2003 to December 2013 were retrospectively studied. The location and site of active hemorrhage or stigmata were analyzed and its relationship with active hemorrhage was discussed. Results A total of 372(45. 2%,372/823) patients with active bleeding and stigmata were found under emergency endoscopy. Among 372 patients, 190 got accurate hemorrhage and stigmata location and site description. Bleeding or stigmata in 58(30. 5%) patients was 28-32 cm from incisor in group A, and that in 132 (69. 5%) patients was more than 35 cm in group B ( χ2＝57. 642, P＜0. 000 1). In 190 cases, the proportion of bleeding or stigmata at 300 point was the highest (37%,70/132), followed by those at 1200 point(30%,58/132),600 point(24%,45/132),and 900 point (9%,17/132). The change trend of the percentage of each point in group A and group B was the same as that in all cases. The percentage of almost all points in group B was significantly higher than that in group A except that at 900 point ( P＜0. 000 1).Conclusion Esophageal variceal bleeding in cirrhosis is more common at 300 point, 600 point and 1200 point of esophagus, and the high risk area is 35 cm below the incisors.