Prognostic blue varices as a discriminant factor of variceal hemorrhage: amendment of the criteria of endoscopic findings of esophageal varices.

Up until now, the endoscopic findings related to hemorrhage from esophageal varices have been red color signs (RCS) and the fundamental bluish color (Cb) of the varices. Although most investigators agree with the former, there is considerable dispute regarding the latter "blue varices". In order to identify the "risky" type of blue varices, prognostic varices (P-Cb) were specifically defined as being featured by a fully expanded appearance with a glossy surface, like an over-inflated balloon. Three hundred and nineteen collected patients with esophageal varices, including 114 bleeders, were retrospectively assessed and the P-Cb was found to have a significant correlation to the bleeding history. The P-Cb should be taken into account when attempting to predict bleeding of blue varices. The general rules for recording endoscopic findings of esophageal varices, as determined in 1980, should thus be amended.