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Noninvasive measurement of the pressure of esophageal varices using an endoscopic gauge: Comparison with measurements by variceal puncture in patients undergoing endoscopic sclerotherapy
Author(s) -
Bosch Jaime,
Bordas José M.,
Rigau Joaquín,
Viola Carmen,
Mastai Ricardo,
Kravetz David,
Navasa Miguel,
Rodés Joan
Publication year - 1986
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.1840060421
Subject(s) - medicine , sclerotherapy , portal hypertension , varices , esophageal varices , varix , portal venous pressure , endoscopy , pressure measurement , gastroenterology , esophagus , surgery , cirrhosis , mechanical engineering , engineering
Measurements of variceal pressure with a noninvasive endoscopic pressure gauge and by direct variceal puncture were performed in 20 cirrhotic patients with portal hypertension in the course of the first session of therapeutic sclerotherapy following an episode of variceal bleeding. Endoscopic gauge measurements of the pressure of esophageal varices gave similar values (15.5 ± 2.7 mm Hg) than measurements by variceal puncture (15.4 ± 2.4 mm Hg; not statistically significant), and there was a highly significant linear correlation between both measurements (r = 0.9, p < 0.001). Azygos blood flow, that was markedly increased in these patients (852 ± 399 ml per min), was directly related to variceal pressure (r = 0.73, p < 0.01). Variceal pressure was significantly lower than portal pressure (18.8 ± 5.0 mm Hg) (p < 0.05), indicating that measurements of variceal pressure cannot substitute measurements of portal pressure. The study demonstrates that the noninvasive endoscopic gauge technique allows an accurate estimation of variceal pressure in patients with portal hypertension. This technique may provide additional useful information in the evaluation of portal hypertension as well as on the mechanism of variceal bleeding.