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CC BY-NC-ND 4.0 · Endosc Int Open 2017; 05(07): E646-E651
DOI: 10.1055/s-0043-107781
Original article
Eigentümer und Copyright ©Georg Thieme Verlag KG 2017

Feasibility of transnasal endoscopy in screening for esophageal and gastric varices in patients with chronic liver disease

Anderson Antônio de Faria
Hospital das Clínicas, Federal University of Mimas Gerais, Alfa Institute of Gastroenterology, Belo Horizonte, Minas Gerais, Brazil
,
Carlos Alberto Freitas Dias
Hospital das Clínicas, Federal University of Mimas Gerais, Alfa Institute of Gastroenterology, Belo Horizonte, Minas Gerais, Brazil
,
Luciana Dias Moetzsohn
Hospital das Clínicas, Federal University of Mimas Gerais, Alfa Institute of Gastroenterology, Belo Horizonte, Minas Gerais, Brazil
,
Silas de Castro Carvalho
Hospital das Clínicas, Federal University of Mimas Gerais, Alfa Institute of Gastroenterology, Belo Horizonte, Minas Gerais, Brazil
,
Tereza Abreu Ferrari
Hospital das Clínicas, Federal University of Mimas Gerais, Alfa Institute of Gastroenterology, Belo Horizonte, Minas Gerais, Brazil
,
Vitor Nunes Arantes
Hospital das Clínicas, Federal University of Mimas Gerais, Alfa Institute of Gastroenterology, Belo Horizonte, Minas Gerais, Brazil
› Author Affiliations
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Publication History

submitted 23 October 2016

accepted after revision 24 March 2017

Publication Date:
06 July 2017 (online)

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Abstract

Background and study aims Screening for esophageal and gastric varices is indicated for patients with portal hypertension or cirrhosis. Typically, conventional endoscopy is used; however, the need for sedation increases the costs and risks, especially in cirrhotic patients. Use of transnasal endoscopy with an ultrathin endoscope enables study of the upper gastrointestinal tract without the need for sedation. The objective of this study is to evaluate the feasibility of transnasal endoscopy in screening for esophageal and gastric varices in patients with chronic liver disease.

Patients and methods This was a prospective study in which transnasal endoscopy was carried out in patients with cirrhosis or portal hypertension who had indications for screening of esophageal and gastric varices. The following variables were evaluated: demographical data, duration of procedure, patient tolerance and acceptance, adverse events (AEs), endoscopic findings and interobserver agreement related to portal hypertension alterations (kappa index).

Results A total of 50 patients entered the study. The most common cause of liver disease was chronic viral hepatitis (66 %). Among the cirrhotic patients, most of the patients were Child-Pugh A (74 %). In 5 patients (10 %), nasal intubation was not possible. Two patients (4 %) experienced minor epistaxis. Tolerance was excellent or good in 92 % according with a visual analogic scale. In 16 patients (32 %), esophageal varices were detected and in 2 patients (4 %) gastric varices were detected. The mean duration of the procedure was 7 minutes.

Conclusions Transnasal endoscopy is feasible, effective and well tolerated for screening of esophageal and gastric varices in patients with chronic liver disease. It can be performed in outpatient clinics safely and without the use of sedation.