Рrediction of bleeding risk from gastric varices using computed tomography: a retrospective study

Introduction: Gastric varices are one of the most significant portal hypertension disorders, characterized by severe disease progression and high mortality. Diagnosis of gastric varices is primarily based on endoscopic findings, while radiologic pattern has been understudied.

Objective: Identification of prognostically significant signs of the risk of bleeding from varicose veins of the stomach and construction of an individual stratification model based on computed tomography data.

Materials and methods: The medical records and CT scan results of 181 patients with portal hypertension were retrospectively analyzed. They were divided into groups with a disease duration of less than 1 year (control group – 109 patients) and more than 5 years (main group – 72 patients). During follow-up, bleeding from gastric varices was noted in 41 patients. All patients underwent CT scanning using standard multiphase scanning techniques, supplemented by hydro-CT.

Statistics: Statistical analysis was performed using Epi Info™ (version 7.2.6.0), Excel (Microsoft Office 2024), and SPSS Statistics (version 26).

Results: Significant differences between the main and control groups were observed in the following parameters: hepatic functional reserve according to the Child-Pugh classification; diameter of gastric varices greater than 7 mm on CT (х²=5,486; p<0,05); degree of variceal protrusion greater than 5 mm on CT (х²=7,533; p<0,01); and the presence of portal hypertensive gastropathy on CT (х²=6,444, p<0,05). Variables were stratified and assessed using a Cox regression model. The prognostic index calculation formula allows for the identification of high, moderate, and low bleeding risks.

Discussion: Most studies focus on esophageal or combined gastroesophageal varices, with limited analysis of gastric variceal features. Our study proposes an integrated prognostic index for gastric variceal bleeding based on computed tomography data.

Conclusion: The obtained results confirm the high informative value of CT in assessing the condition of gastric varices. The use of a CT-based bleeding prognostic index allows for individualized patient management.

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