Premium
Endoscopic markers of impending varceal hemorrhage: Correlation with the pressure in the varices
Author(s) -
Beppu Kazushige,
Hashizume Makoto
Publication year - 1990
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.1840110127
Subject(s) - ascites , esophageal varices , cirrhosis , medicine , varices , portal hypertension , gastroenterology , portal venous pressure , endoscopy
In 40 patients with cirrhosis and esophageal varices, transmural variceal pressure was assessed endoscopically by fine needle puncture and related to endoscopicsigns as well as to the severity of liver disease. Transmural pressure was significantly (p < 0.01) higher in the presence of a red color sign (26.7[7.8] cm H 2 O) than in its absence (19.1 [6.6] cm H 2 ). Transmural pressure, however, was not significantly related to diameter or number of varices (diameter >5mm: 23.7 [8.4], diameter ≦ 5 mm: 22.2 [7.9] cm H 2 0; number > 3: 23.2 [8.0], number ≦ 3: 22.2 [7.8] cm H 2 O. The Child status (Child A: 23.9 [8.0], Child B/C: 21.3 [8.1] cm H 2 O) and individual Child‐Pugh parameters including ascites (ascites present: 23.2 [8.3] cm H 2 O, ascites absent: 22.8 [8.1] cm H 2 O) were not significantly related to transmural variceal pressure. We conclude that the endoscopic visibility of a red color sign on the varices is associated with a high transmural esophageal variceal pressure. Our results favor the hypothesis that variceal pressure may be of major importance for the development of the red color sign.