食道静脈瘤の内視鏡的検討

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タイトル別名
  • Clinical Studies of Esophageal Varices
  • ショクドウ ジョウミャクリュウ ノ ナイシキョウテキ ケントウ

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Sixty-two cases of esophageal varices have been examined in our hospital for the last one and a half years. Bleeding varices were found in 32 cases. The characteristic differences in the esophagoscopic findings between bleeding and non-bleeding varices were as follows. (1) Varices extending the entire length of the esophagus were seen in the bleeding cases more often. (2) Bluish varices were seen in 25% of the bleeding cases, while they were found in 8% of the non-bleeding cases. The red sign was found in the majority of the bleeding cases. (3) The tumorous and nodular forms of varices were found in the bleeding cases more frequently. (4) Erosive esophagitis was rare, and it was seen in only 2 of the bleeding cases.<br>Forward viewing fiberscopes, such as the esophagofiberscope and the pan-endoscope, were utilized for the examination of the varices. An esophagofiberscope with a tip bendable up to 210 degrees was especially appropriate for observation throughout the esophagus and the gastric cardia.<br>In 334 cases of urgent endoscopy, gastric or duodenal ulcers were found in 51%. Esophageal varices were seen in 11%, in some of which gastric and/or duodenal lesions were also found.<br>For the surgical treatment of esophageal varices, esophageal transection, splenectomy and devascularization around the stomach have been carried out. Transection of the esophagus was easily performed using a sewing instrument. In a long-term follow-up over one year after surgery, a relapse of varices was seen in 10% of the cases.

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