原発性胆汁性肝硬変症における食道・胃静脈瘤の検討

高橋 敦史; 物江 恭子; 坂本 夏美; 菅野 有紀子; 斉藤 広信; 阿部 和道; 横川 順子; 渋川 悟朗; 高木 忠之; 引地 拓人; 入澤 篤志; 小原 勝敏; 大平 弘正

doi:10.11423/jsph.17.1

Original Articles

Esophagogastric varices in patients with primary biliary cirrhosis

Atsushi Takahashi, Kyoko Monoe, Natsumi Sakamoto, Yukiko Kanno, Hironobu Saito, Kazumichi Abe, Junko Yokokawa, Goro Shibukawa, Tadayuki Takagi, Takuto Hikichi, Atsushi Irisawa, Katsutoshi Obara, Hiromasa Ohira

Author information

Atsushi Takahashi
Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine
Kyoko Monoe
Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine
Natsumi Sakamoto
Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine
Yukiko Kanno
Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine
Hironobu Saito
Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine
Kazumichi Abe
Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine
Junko Yokokawa
Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine
Goro Shibukawa
Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine
Tadayuki Takagi
Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine
Takuto Hikichi
Department of endoscopy, Fukushima Medical University School of Medicine
Atsushi Irisawa
Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine
Katsutoshi Obara
Department of endoscopy, Fukushima Medical University School of Medicine
Hiromasa Ohira
Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine

Keywords: PBC, portal hypertension, esophagogastric varices

JOURNAL FREE ACCESS

2011 Volume 17 Issue 1 Pages 1-5

DOI https://doi.org/10.11423/jsph.17.1

Details

Abstract

In this study, we analyzed occurrence and recurrence of esophagogastric varices in 84 patients with primary biliary cirrhosis (PBC). Esophagogastric varices were observed in 20 of 84 patients (23.8%) with PBC. Histological study of 18 patients, in whom varices had already existed at diagnosis, revealed that 6 cases (33.3%) were at the Scheuer's stage I or II, and 12 cases (66.7%) were at stage III or IV. The varicescomplicated group was more likely to be associated with female gender, splenomegaly and pruritus than the non-complicated group. Analysis of laboratory and histological findings showed that prothrombin time and platelets were significantly lower and the histological stage was more advanced in the complicated group. Recurrence was found in 6 cases (35.3%) among 17 patlents who were endoscopically treated. Laboratory findings were not significantly different between the recurrence group and the non-recurrence group.
We reconfirmed that esophagogastric varices are observed in patients with PBC at early histological stages. This observation suggests that anatomical differences of collateral circulation surrounding the esophagus or stomach is, in addition to portal venous pressure, important in the development of esophageal varices of PBC.

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