Dagradi A E, Arguello J F, Weingarten Z G
Am J Gastroenterol. 1979 Oct;72(4):395-402.
In a series of 500 patients undergoing emergency endoscopic examination to detect the source(s) for upper gastrointestinal bleeding, the examination failed in its purpose in 55 cases (11%). This group was analyzed. Thiry-seven of these individuals demonstrated large and extensive esophagogastric varices which, while not observed to bleed during the examination, represented a potential bleeding source of great significance. The clinical implication of this endoscopic finding is described. Variceal bleeding frequently recurs sporadically, ceases abruptly and leaves no visible evidence of the point of rupture. Lacking this latter factor, the endoscopist is usually reluctant to assign responsibility for bleeding to these lesions. When, however, large varices are discovered as the sole potential source for bleeding, they may be assumed, with good reason, to represent the actual source and specific treatment logically may be instituted.
在一组500例接受急诊内镜检查以确定上消化道出血来源的患者中，有55例（11%）检查未达到目的。对这组患者进行了分析。其中37例显示有巨大且广泛的食管胃静脉曲张，这些静脉曲张在检查期间虽未观察到出血，但却是具有重大意义的潜在出血源。描述了这一内镜检查结果的临床意义。静脉曲张出血经常间歇性复发，突然停止，且没有破裂点的明显迹象。由于缺乏后一个因素，内镜医师通常不愿将出血责任归咎于这些病变。然而，当发现大的静脉曲张是唯一潜在的出血源时，有充分理由认为它们可能是实际出血源，从而可以合理地进行特定治疗。
