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要旨●EUSを行わずとも,食道・胃静脈瘤の治療は可能である.しかし,治療前にEUSによる静脈瘤局所の血行動態を把握することは,より安全かつ効果的な治療遂行につながる.また,治療後のEUS観察は,通常内視鏡観察では判断が難しい静脈瘤内残存血流についても情報を与えてくれるため,追加治療の必要性が理解できる.このように,“丁寧な静脈瘤診療”において,EUSは欠かせないツールである.また,近年では,EUSは診断のみならず静脈瘤治療にも応用されている.EUS-FNA(EUS-guided fine needle aspiration)の技術を応用したEUSガイド下胃静脈瘤内コイル留置術は今後の新たな内視鏡治療としてその発展が期待されている.
Esophagogastric varices may be treated without the use of EUS(endoscopic ultrasonography)imaging. However, understanding the local hemodynamics of the varices using EUS imaging prior to treatment leads to safe and effective treatment. In addition, EUS imaging performed after treatment also provides information on residual blood flow in the varices, which is usually difficult to detect using endoscopes. Hence, the requirement for additional treatment may be determined. EUS imaging is an indispensable tool for the careful management of varices. In recent years, EUS imaging has been applied to both the diagnosis and treatment of gastric varices. Coil deployment in gastric varices using EUS-fine needle aspiration technology is expected to develop as a new endoscopic treatment.
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