fibrin and Esophageal-and-Gastric-Varices

A 58-year-old man with hepatitis B cirrhosis noticed black stools and underwent an endoscopy at a community hospital. The presence of esophageal varices (EVs) was confirmed, but the bleeding point was not found. He was referred to our institution and underwent a second endoscopy. Extensive white patches of esophageal candidiasis were visible on endoscopy by white-light imaging (WLI), but it was difficult to find the fibrin cap of the EVs. This was easier under narrow-band imaging (NBI), however, as the color turned red from absorption by hemoglobin adhered to it. We retrospectively measured the color differences (CD) between the fibrin cap and the surrounding mucosa 10 times using the CIE (L*a*b*) color space method. The median value of CD increased after NBI (13.9 → 43.0, p < 0.001), with increased visibility. However, the median CD between the white patch and surrounding mucosa decreased after NBI (44.8 → 30.3, p < 0.001). The fibrin cap was paler than the white patch of candidiasis, but the increased visibility of the fibrin cap by NBI enabled it to be found more easily. This is the first report of a case in which NBI was helpful in locating a fibrin cap of EVs.

Topics: Candidiasis; Color; Esophageal and Gastric Varices; Esophagoscopy; Fibrin; Gastrointestinal Hemorrhage; Humans; Male; Middle Aged; Narrow Band Imaging

Topics: Abdomen, Acute; Blood Platelets; Endoscopy, Gastrointestinal; Esophageal and Gastric Varices; Fibrin; Hematemesis; Humans; Hypertension, Portal; Ligation; Liver Cirrhosis; Male; Middle Aged; Pressure; Rupture, Spontaneous; Treatment Outcome; Varicose Veins

Topics: Blood Platelets; Esophageal and Gastric Varices; Esophagoscopy; Fibrin; Gastrointestinal Hemorrhage; Humans

Topics: Adolescent; Adult; Blood Coagulation Tests; Child; Chronic Disease; Esophageal and Gastric Varices; Female; Fibrin; Humans; Liver Cirrhosis; Liver Diseases; Male; Middle Aged; Polymers; Portacaval Shunt, Surgical; Prognosis

Topics: Catheterization; Coronary Vessels; Embolization, Therapeutic; Esophageal and Gastric Varices; Fibrin; Gastrointestinal Hemorrhage; Gelatin Sponge, Absorbable; Glucose; Humans; Injections, Intravenous; Male; Middle Aged; Sclerosing Solutions; Stomach; Stomach Diseases; Veins

Topics: Adult; Alpha-Globulins; Aminocaproates; Blood Coagulation Disorders; Blood Coagulation Factors; Blood Coagulation Tests; Esophageal and Gastric Varices; Factor V; Factor VII; Factor X; Female; Fibrin; Fibrinolysin; Fibrinolysis; Gastrointestinal Hemorrhage; Humans; Liver Cirrhosis; Macroglobulins; Male; Middle Aged; Plasminogen; Protamines

Topics: Aged; Esophageal and Gastric Varices; Fibrin; Gastritis; Gastrointestinal Hemorrhage; Gastrointestinal Neoplasms; Hemostasis; Humans; Peptic Ulcer; Thrombin