OBJECTIVETo compare the characteristics of esophageal gastric varices in portal hypertension patients with and without spontaneous shunts.

METHODSClinical data of 118 patients with esophageal gastric varices undergoing portal vein computed tomographic angiography (CTA) and gastroscopy between January 2012 and August 2015 was retrospectively reviewed.

RESULTSPortal vein CTA results showed that spleno-renal or gastro-renal shunts were detected in 24 out of 118 cases. The average portal vein diameters (PVD) of patients with and without spontaneous shunt were (12.48±2.79) mm and (13.58±3.46) mm, respectively (P>0.05). The average area of gastric veins in patients with spontaneous shunt was significantly larger than that of patients without shunt [294.00 (0.00~2400.00) mm2 vs. 26.00 (0.00~1620.00) mm2, respectively, (P<0.001]. Compared with patients without spontaneous shunt, the location of esophageal varices was lower and the degree was less serious in patients with spontaneous shunt (P<0.05). No matter with history of uppergastrointestinal bleeding, the average area of gastric veins in patients with spontaneous shunt was significantly larger than that of patients without shunt (P<0.05). For patients having no history of splenectomy, the average portal vein diameter (PVD) in those with spontaneous shunt was significantly smaller than that in those without shunt (P<0.05).

CONCLUSIONThe portal vein diameter of patients without splenectomy and with spontaneous shunts is shorter and their esophageal varices are less serious; the gastric veins are large and wriggly in patients with spontaneous shunts.

Angiography ; Esophageal and Gastric Varices ; physiopathology ; Gastroscopy ; Humans ; Hypertension, Portal ; physiopathology ; Portal Vein ; pathology ; Retrospective Studies ; Spleen ; Tomography, X-Ray Computed