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World J Gastroenterol. Feb 7, 2007; 13(5): 791-795
Published online Feb 7, 2007. doi: 10.3748/wjg.v13.i5.791
Per rectal portal scintigraphy as a useful tool for predicting esophageal variceal bleeding in cirrhotic patients
Taned Chitapanarux, Ong-ard Praisontarangkul, Satawat Thongsawat, Pises Pisespongsa, Apinya Leerapun
Taned Chitapanarux, Ong-ard Praisontarangkul, Satawat Thongsawat, Pises Pisespongsa, Apinya Leerapun, Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
Author contributions: All authors contributed equally to the work.
Supported by the Gastroenterological Association of Thailand
Correspondence to: Dr. Taned Chitapanarux, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand. thaitaned@yahoo.com
Telephone: +66-53-945482 Fax: +66-53-945481
Received: October 24, 2006
Revised: December 7, 2006
Accepted: January 8, 2007
Published online: February 7, 2007
Abstract

AIM: To investigate potential roles of per rectal portal scintigraphy in diagnosis of esophageal varices and predicting the risk of bleeding.

METHODS: Fifteen normal subjects and fifty cirrhotic patients with endoscopically confirmed esophageal varices were included. Patients were categorized into bleeder and non-bleeder groups according to history of variceal bleeding. All had completed per rectal portal scintigraphy using 99mTechnetium pertechnetate. The shunt index was calculated from the ratio of 99mTechnetium pertechnetate in the heart and the liver. Data were analyzed using Student’s t-test and receiver operating characteristics.

RESULTS: Cirrhotic patients showed a higher shunt index than normal subjects (63.80 ± 25.21 vs 13.54 ± 6.46, P < 0.01). Patients with variceal bleeding showed a higher shunt index than those without bleeding (78.45 ± 9.40 vs 49.35 ± 27.72, P < 0.01). A shunt index of over 20% indicated the presence of varices and that of over 60% indicated the risk of variceal bleeding.

CONCLUSION: In cirrhotic patients, per rectal portal scintigraphy is a clinically useful test for identifying esophageal varices and risk of variceal bleeding.

Keywords: Portal scintigraphy; Portal hypertension; Cirrhosis; Esophageal varices; Bleeding