Pitfalls in the reporting of upper endoscopy features in cirrhotic patients

Silvia Cucchiarelli, Francesco Santopaolo, Antonietta Lamazza, Raffaella Lionetti, Ilaria Lenci, Tommaso Maria Manzia, Mario Angelico, Martina Milana, Leonardo Baiocchi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Upper endoscopy is the main tool for the accurate assessment of the risk of bleeding in cirrhotic patients. Aim: To evaluate the diagnostic accuracy of upper endoscopy, in cirrhotic subjects, during common clinical practice. Methods: 120 endoscopic reports produced in different hospitals in our region were retrospectively and randomly selected. After a general evaluation, aimed at assessing the description of various endoscopic features, reports were evaluated by four expert endoscopists and four expert hepatologists. Experts were asked to fill in a questionnaire for each single endoscopic procedure, regarding the diagnostic accuracy of the report. Results: Endoscopic reports lacked descriptions of the size of esophageal varices and red signs in 14% and 29% of cases respectively. Presence (or absence) of gastric varices or portal hypertensive gastropathy were not reported in 62% and 34% of cases respectively. According to expert endoscopists 41% of the reports were incomplete, while, according to hepatologists, reports were incomplete and inadequate for clinical purposes in 36% of cases. Conclusion: Our study clearly evidenced a significant lack of information in reports on upper endoscopy in cirrhotic patients, and supports the prompt adoption of corrective strategies.

Original languageEnglish
JournalDigestive and Liver Disease
DOIs
Publication statusE-pub ahead of print - Aug 18 2018

Keywords

  • Esophageal varices
  • Hepatology
  • Portal hypertension
  • Survey

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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