Esophageal varices and sarin's classification for gastric varices

    Esophageal varices

    Grade 1: Varices disappear with air insufflation
    Grade 2: Non-confluent varices remain identical with air insufflation
    Grade 3: Confluent varices remain identical with air insufflation

    Grade 4: Confluent varices remain identical with air insufflation and red signs (cherry, red spots, red wale markings, hematocytic spots,

    telangiectasia and varices overlying spots)

    Schäppi MG et al; Pediatric gastrointestnal disease, 2008; 1265-82

    Sarin's classification for gastric varices

    • GOV1: Gastroesophageal varices types 1, an extension of esophageal along the lesser covature

    • GOV2: Gastroesophageal varices types 2, an extension of esophageal along the fundus

    • IGV1: Isolated gastric varices in the fundus

    • IGV2: Isolated gastric varices not in the fundus

     


    Al-Osaimi AMS, Medical and Endoscopic Management of Gastric Varices, seminars in interventional radiology 28 (3) 2011

    Initial Management

    • Resuscitation (Hb 8g/dl)

    • Medicine: Vasopressin, Somatostatin (Octreotide), β-blockers, PPI

    • Endoscopy: Sclerotherapy; banding; ligation injection of cyanoacrylate glue for gastric varices

    • Transjugular intrahepatic portosystemic shunts

    • Surgery

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