Diagnosis Varises Esofagus

Oleh :

dr. Agnes Tjakrapawira

Diagnosis varises esofagus ditegakkan dengan baku emas esofagogastroduodenosskopi (EGD) dan secara klinis mungkin asimtomatik. Gejala perdarahan saluran cerna atas seperti hematemesis dan hematochezia biasanya muncul jika terjadi ruptur atau komplikasi.[4–8]

Anamnesis

Varises esofagus sering kali jarang menimbulkan gejala. Kebanyakan pasien baru terdiagnosis ketika terjadi episode perdarahan gastrointestinal seperti hematemesis, hematochezia, dan melena.

Karena penyebab tersering adalah sirosis hepatis, maka anamnesis perlu dilakukan untuk mendeteksi sirosis hepatis. Pertanyaan dapat mencakup riwayat konsumsi alkohol, hepatitis, penurunan berat badan, anoreksia, nyeri perut, ikterus, pruritus, ataupun perubahan status mental yang merupakan gejala ensefalopati.[4–8,15]

Referensi

1. Kovacs TOG, Jensen DM. Varices: Esophageal, Gastric, and Rectal. Clin Liver Dis. 2019;23(4):625-642. doi:10.1016/j.cld.2019.07.005
2. Mattos ÂZ, Schacher FC, John Neto G, Mattos AA. Screening for esophageal varices in cirrhotic patients - Non-invasive methods. Ann Hepatol. 2019;18(5):673-678. doi:10.1016/j.aohep.2019.06.003
4. Kraja B, Mone I, Akshija I, Koçollari A, Prifti S, Burazeri G. Predictors of esophageal varices and first variceal bleeding in liver cirrhosis patients. World J Gastroenterol. 2017;23(26):4806-4814. doi:10.3748/wjg.v23.i26.4806
5. Pateu E, Oberti F, Calès P. The noninvasive diagnosis of esophageal varices and its application in clinical practice. Clin Res Hepatol Gastroenterol. 2018;42(1):6-16. doi:10.1016/j.clinre.2017.07.006
6. Abe H, Midorikawa Y, Matsumoto N, et al. Prediction of esophageal varices by liver and spleen MR elastography. Eur Radiol. 2019;29(12):6611-6619. doi:10.1007/s00330-019-06230-8
7. Meseeha M, Attia M. Esophageal Varices. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK448078/
8. Triantos C, Kalafateli M. Endoscopic treatment of esophageal varices in patients with liver cirrhosis. World J Gastroenterol. 2014;20(36):13015-13026. doi:10.3748/wjg.v20.i36.13015
13. Pimenta JR, Ferreira AR, Fagundes ED, et al. Factors Associated With Bleeding Secondary to Rupture of Esophageal Varices in Children and Adolescents With Cirrhosis. J Pediatr Gastroenterol Nutr. 2017;64(2):e44-e48. doi:10.1097/MPG.0000000000001362
14. Carlson DS, Pfadt E. Bleeding esophageal varices. Nursing. 2012;42(12):72. doi:10.1097/01.NURSE.0000422664.70404.af
15. Shaheen AA, Nguyen HH, Congly SE, Kaplan GG, Swain MG. Nationwide estimates and risk factors of hospital readmission in patients with cirrhosis in the United States. Liver Int. 2019;39(5):878-884. doi:10.1111/liv.14054
16. Yoon H, Shin HJ, Kim MJ, et al. Predicting gastroesophageal varices through spleen magnetic resonance elastography in pediatric liver fibrosis. World J Gastroenterol. 2019;25(3):367-377. doi:10.3748/wjg.v25.i3.367
17. Nery F, Correia S, Macedo C, et al. Nonselective beta-blockers and the risk of portal vein thrombosis in patients with cirrhosis: results of a prospective longitudinal study. Aliment Pharmacol Ther. 2019;49(5):582-588. doi:10.1111/apt.15137
18. Chakinala RC, Kumar A, Barsa JE, et al. Downhill esophageal varices: a therapeutic dilemma. Ann Transl Med. 2018;6(23):463. doi:10.21037/atm.2018.11.13
19. Zampino R, Lebano R, Coppola N, et al. The use of nonselective beta blockers is a risk factor for portal vein thrombosis in cirrhotic patients. Saudi J Gastroenterol. 2018;24(1):25-29. doi:10.4103/sjg.SJG_100_17
20. Monreal-Robles R, Cortez-Hernández CA, González-González JA, et al. Acute Variceal Bleeding: Does Octreotide Improve Outcomes in Patients with Different Functional Hepatic Reserve?. Ann Hepatol. 2018;17(1):125-133. doi:10.5604/01.3001.0010.7544
21. Boregowda U, Umapathy C, Halim N, Desai M, Nanjappa A, Arekapudi S, Theethira T, Wong H, Roytman M, Saligram S. Update on the management of gastrointestinal varices. World J Gastrointest Pharmacol Ther. 2019 Jan 21;10(1):1-21. doi: 10.4292/wjgpt.v10.i1.1. PMID: 30697445; PMCID: PMC6347650.
22. Abby Philips C, Sahney A. Oesophageal and gastric varices: historical aspects, classification and grading: everything in one place. Gastroenterol Rep (Oxf). 2016 Aug;4(3):186-95. doi: 10.1093/gastro/gow018. Epub 2016 Jun 19. PMID: 27324725; PMCID: PMC4976684.

(Konten ini khusus untuk dokter. Registrasi untuk baca selengkapnya)

Masuk atau Daftar

Nomor Ponsel Sudah Terdaftar

Masuk dengan Email

Masuk dengan Email

Masuk dengan Facebook

Diagnosis Varises Esofagus

Referensi

Masuk atau Daftar

Artikel Terkait