Position Changes in Endoscopic Cirrhosis Variceal Hemorrhagic Spot Detection: a Retrospective Study of 11 Cases

The patients who conducted position change due to massive EGVB resulting in poor visualization in the stomach were included. Those with incomplete information were excluded. The patients were characterized in terms of age, sex, causes of liver cirrhosis, adverse events (AEs) during position change, additional findings after body position change, treatment regimens and follow-up information.

The gastroscopes procedure was started in the left lateral position in all patients. Bleeding varices detected before the position change were stopped by the endoscopic hemostatic measures described above. The following conditions would consider a change of position during gastroscopy: (1) A large amount of blood or blood clot was found after reaching the stomach, making it difficult to suction adequately which led to poor mucosal visuality; (2) Persistent massive bleeding from a blood vessel that filled the stomach cavity rapidly after suction, making it impossible to clarify the bleeding vessel.During position changing procedure, endoscopist withdrew the gastroscope from the stomach and patients changed from the left lateral position to the right lateral position with the help of the nurses. Then endoscopist reinserted the gastroscope into the stomach and tried to detect the addition varices after position change.

Bleeding varices were treated by injection of N-butyl-Cyanoacrylate glue (glub B or Beltran, Compex) or/and Lauromacrogol (Shanxi, Tianyu).