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Tests and diagnosis
By Mayo Clinic staffIf you have cirrhosis or other serious liver disease, your doctor may screen you for esophageal varices, sometimes as often as every year or two. These tests are usually used to look for varices:
- Endoscopy. For this test, your doctor inserts a thin, flexible, lighted tube (endoscope) through your mouth and into your esophagus. If any dilated veins are found, they're graded according to their size and checked for red streaks, which usually indicate a significant risk of bleeding. An esophageal endoscopy takes about 20 to 30 minutes, and the risks are generally minor. The most common side effect is a sore throat from swallowing the endoscope.
- Imaging tests. Both computerized tomography (CT) scans and magnetic resonance imaging (MRI) may be used to diagnose esophageal varices. Unlike an endoscopy, these noninvasive tests also allow your doctor to examine your liver and circulation in the portal vein. But imaging tests aren't as effective at finding varices as endoscopy is, and they're not as useful for determining which varices are likely to bleed. For that reason, they're most often used in addition to endoscopy or when endoscopy can't be performed.
References
- Dite P, et al. World Gastroenterology Organisation Practice Guidelines: Esophageal Varices. World Gastroenterology Organisation. http://www.worldgastroenterology.org/assets/downloads/en/pdf/guidelines/18_treatment_e_varices_en.pdf. Accessed Aug. 21, 2008.
- Sanyal, AJ. General principles of the management of variceal hemorrhage. http://www.uptodate.com/home/index.html. Accessed Aug. 21, 2008.
- Runyon, BA. Patient information: Screening for esophageal varices. http://www.uptodate.com/home/index.html. Accessed Aug. 21, 2008.
- Goff JS. Endoscopic variceal ligation. http://www.uptodate.com/home/index.html. Accessed Aug. 21, 2008.
- Portal hypertension. Merck Manuals Online Medical Library. http://www.merck.com/mmhe/print/sec10/ch135/ch135d.html. Accessed Aug. 21, 2008.
- Sanyal, AJ. Prediction of variceal hemorrhage. http://www.uptodate.com/home/index.html. Accessed Aug. 21, 2008.
- Sanyal, AJ. Treatment of active variceal hemorrhage. http://www.uptodate.com/home/index.html. Accessed Aug. 21, 2008.
- Sanyal, AJ. Primary prophylaxis against variceal hemorrhage in patients with cirrhosis. http://www.uptodate.com/home/index.html. Accessed Aug. 21, 2008.
- Sanyal, AJ. Prevention of recurrent variceal hemorrhage in patients with cirrhosis. http://www.uptodate.com/home/index.html. Accessed Aug. 20, 2008.
- Picco MF (expert opinion). Mayo Clinic, Jacksonville, Fla. Aug. 24, 2008.
