Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 16, 2022; 10(17): 5620-5633
Published online Jun 16, 2022. doi: 10.12998/wjcc.v10.i17.5620
Difference between type 2 gastroesophageal varices and isolated fundic varices in clinical profiles and portosystemic collaterals
Yu-Hu Song, Hong-Yu Xiang, Ke-Ke Si, Ze-Hui Wang, Yu Zhang, Chang Liu, Ke-Shu Xu, Xin Li
Yu-Hu Song, Hong-Yu Xiang, Ze-Hui Wang, Chang Liu, Ke-Shu Xu, Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
Ke-Ke Si, Yu Zhang, Xin Li, Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
Ke-Ke Si, Yu Zhang, Hubei Province Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
Author contributions: Li X and Xiang HY contributed equally to this work; Song YH designed the study; Li X, Xiang HY, Si KK, Wang ZH and Song YH performed the research and collected data; Xiang HY, Li X and Song YH wrote the paper; Li X, Xiang HY, Si KK, Wang ZH, Liu C, Song YH, Xu KS, Song YH analyzed the data, reviewed the chart; Xiang HY, Si KK, Wang ZH, Liu C and Song YH performed statistical analysis.
Supported by National Natural Science Foundation of China, No. 82070631.
Institutional review board statement: The study was conducted according to the principles of the Declaration of Helsinki, and the protocol was approved by the ethics committee of Tongji Medical College, Huazhong University of Science and Technology (No. 2020-S216) and registered at www.chictr.org.cn (ChiCTR 2100042267).
Informed consent statement: The requirement for informed consent was waived because of retrospective study.
Conflict-of-interest statement: All authors have nothing to disclose
Data sharing statement: All authors had access to the study data and reviewed and approved the final manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin Li, MD, PhD, Chief Doctor, Professor, Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Avenue, Wuhan 430022, Hubei Province, China. lxwsry2014@163.com
Received: December 8, 2021
Peer-review started: December 8, 2021
First decision: March 11, 2022
Revised: March 17, 2022
Accepted: April 9, 2022
Article in press: April 9, 2022
Published online: June 16, 2022
Processing time: 182 Days and 14.7 Hours
ARTICLE HIGHLIGHTS
Research background

There is significant heterogeneity between gastroesophageal varices (GOV2) and isolated gastric varices (IGV1). The data on the difference between GOV2 and IGV1 are limited.

Research motivation

The Sarin classification does not truly describe the heterogeneity in the etiology and vascular alternation. Thus, studies should be performed to determine the etiology, clinical profiles, and imaging signs in patients with GOV2 and IGV1.

Research objectives

The Sarin classification does not truly describe the heterogeneity in the etiology To obtain a better understanding of fundic varices (GOV2 and IGV1), a large sample of patients (119 patients with GOV2, 133 patients with IGV1) was enrolled, and then the etiology, clinical profiles, endoscopic findings, imaging signs, and portosystemic collateral veins in patients with fundic varices were investigated in our study. The data in our study are helpful in making therapeutic decisions.

Research methods

The authors retrospectively collected the medical records of 252 patients with gastric fundal varices, and analyzed computed tomography images.

Research results

Significant differences in the etiology, blood routine examination, liver function, the incidence of peptic ulcer and the morbidity of portal hypertensive gastropathy were found between GOV2 and IGV1. Typical radiological signs of liver cirrhosis were more commonly observed in patients with GOV2 compared with IGV1. Spleno-gastroomental-superior mesenteric shunt was a major collateral vessel of IGV1 patients caused by the obstruction of the splenic vein. Gastro-renal shunt or gastrocaval shunt occurred in GOV2 patients with small size of esophageal varices and IGV1 patients caused by liver cirrhosis

Research conclusions

These findings highlight the differences in the etiology, clinical profiles, endoscopic findings, imaging signs, portosystemic collaterals between patients with GOV2 and patients with IGV1. Knowledge of the etiology and portosystemic collaterals in our study is helpful in making therapeutic decisions.

Research perspectives

A multicenter study should be performed to determine the differences in the etiology, clinical profiles, endoscopic findings, imaging signs, portosystemic collaterals between patients with GOV2 and patients with IGV1. A prospective RCT study should be performed to determine therapeutic interventions for patients with GOV2 or IGV1.