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Junctional varices as an important cause for recurrent variceal bleeding

Gastroenterology & Hepatology: Open Access
Mazen Naga,1 Serag Esmat,1 Ahmed Elbadri,1 Hussein Okasha,1 Yehia M Naga2


Background and study aims: Bleeding from gastric varices is a life threatening complication of portal hypertension. 
Methods: This work included 166 patients with gastric varices among 443 Egyptian patients with variceal bleeding, 88 (53%) patients with junctional varices and 89 (53.6%) patients with fundal varices and 11 patients had both types of varices. All patients were injected by cyanoacrylate and followed up for the recurrence of varices and the variceal rebleeding for a period of 6.5+1.2months. 
Results: Thirty four out of 88 (38.6%) patients with junctional varices had rebleeding. Rebleeding occurred in 11 out of 89 (12.4%) patients with fundal varices. The total incidence of rebleeding of junctional varices was significantly higher than the incidence of rebleeding in fundal varices (P< 0.001). 
Conclusion: Junctional varices has a significantly high rate of rebleeding as they may be easily missed during endoscopic examination as they are usually multiple and are frequently mistaken for gastric folds especially if they are not actively bleeding.


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