Scoring System of Snady and Feinman for Predicting Hemorrhage from Esophageal Varices

A score based on the endoscopic appearance of esophageal varices correlates with the risk of variceal bleeding in cirrhotics who have never bled.

Parameters:

(1) form and size

(2) location

(3) color

(4) red color sign

Parameter	Code	Finding	Points
form or size	F1	small, straight varices not disappearing with insufflation	1
	F2	large varices occupying less than one third of the lumen	2
	F3	large, coil-shaped varices occupying more than one-third of the lumen	3
location	Li	varices located within the lower one-third of the esophagus (distal 6 cm)	0
	Lm	varices located within the lower two-thirds of the esophagus below the tracheal bifurcation	1
	Ls	varices extending above the tracheal bifurcation to the cricopharyngeus	2
Color	Cw	white varices appearing like large folds of esophageal mucosa	0
	Cbw	varices that cannot be clearly assigned as Cw or Cb	1
	Cb	dark blue varices, appearing cyanotic	2
Red color sign	0	absent	0
	+	present but no more than 10 lesions seen in esophagus	1
	++	more than 10 lesions are easily visible but not extensive	2
	+++	extensive, covering all varices in the entire esophagus	3

score for endoscopic findings =

= SUM(points for the 4 parameters)

Interpretation:

• minimum score: 1

• maximum score: 10

• Almost all patients with high grade varices can be expected to bleed within 2 years.

To read more or access our algorithms and calculators, please log in or register.