Endoscopic Ultrasonographic Study of the Azygos Vein in Patients with Varices

Abstract

Background and Study Aims: Using EUS in the study of portal hypertensive patients, various divisions of the gastroesophageal collateral circulation can be demonstrated. The azygos vein, which is the main drainage system for varices, can also be scanned endosonographically. We studied the azygos vein in control subjects and portal hypertensive patients using EUS.

Patients and Methods: Our study included 17 patients with endoscopic evidence of esophagogastric varices and 11 control subjects not suffering from chronic liver disease or varices. EUS and Doppler EUS using a linear scanning echoendoscope were carried out on patients and control subjects with the aim of studying the azygos vein.

Results: The azygos vein could be scanned in all subjects and was found to be significantly dilated in patients with varices. Maximal velocity of its blood flow was higher among patients with varices compared to control subjects. Periazygos collaterals could be occasionally observed in portal hypertensive patients.

Conclusion: EUS can be used both for scanning and hemodynamic studies of the azygos vein. The fact that EUS allows the collection of valuable quantitative and qualitative data from the azygos vein should encourage further studies on the clinical value of this information in the follow up of portal hypertensive patients.