Etiology Analysis And Treatment Of 86 Case Gastric Varices

Objective: The etiology of Gastric varices is complex,its treatment is still controversial,this study was designed to retrospective analysis 86 case gastric varices in the diagnosis,treatment and prognosis,in order to guide the diagnosis and treatment of isolated Gastric varices.Methods:The data of 86 patients with gastric varices hospitalized at the First Affiliated Hospital of Nanjing Medical University between January 2010 and March 2017 were collected.The data of etiology,clinical presentation and therapeutic modalities were retrospective.Results:The etiologies of gastric fundal varices were liver cirrhosis related portal hypertension(n=41,51.90%),left-sided portal hypertension(n=31,39.24%),unknow origin(n=6,7.59%),portal cavernous transformation(n=1,1.27%);The etiology of gastric fundal and gastricum varices were left-sided portal hypertension(n=3),hemopathy related portal hepertension(n=3),hepatic arterio-portal venous fistula(n=1).(2)32 case of gastric fundal varices cause by Liver cirrhosis received endoscopic tissue adhesive injection,1 of them rebleeding in 1month;9 case of gastric fundal varices cause by Liver cirrhosis received medical treatment,3 of them rebleeding in 1 month.The differences was statistically significant(p>0.05).(3)9 case of gastric fundal varices cause by left-sided portal hypertension received endoscopic tissue adhesive injection,1 of them rebleeding in 1month;3 of them rebleeding in 1 year.13 case of gastric fundal varices cause by left-sided portal hypertension received splenectomy,no one of them rebleeding in 1 year.There was a statistical difference in the incidence of rebleeding rate between the two groups(33.33%vs7.69%)(p<0.05).(4)Patient with gastric fundal and gastricum varices only one case receive medical treatment occurrence rebleeding,other are had a good therapeutic effect.Conclusion: The cause of isolated gastric varices in addition to the liver cirrhosis relation portal hypertension,also have left-side portal hypertension,blood system related diseases,Abdominal tuberculosis and hepatic arterial-portal venous fistula,et.Due to different causes we should select the appropriate medication,endoscopy,Interventional,surgery,so as to improve the treatment effect.