[Show abstract][Hide abstract] ABSTRACT: To study the role of perforating veins in predicting the likelihood of esophageal variceal rupture and variceal recurrences.
In 70 patients with esophageal varices, a 20 MHz ultrasonographic transducer was used to image esophageal varices; the radius and perforating veins were calculated. Esophageal variceal pressure measurements were obtained by noninvasive pressure gauge. The relationship between the size of esophageal varices and the presence of perforating veins in the esophageal wall was studied using chi-square test; the patients were divided into two groups according to the presence of perforating veins, and the pressure in each group was compared by using Student's t test. In addition, the frequency of endoscopy sessions necessary for varix eradication, the dots of endoscopic variceal ligation and recurrence of esophageal varices within a year were also compared by the Mann-Whitney U test.
The presence of perforating veins in the esophageal wall was significantly higher in patients with large radius of varices than in patients with small radius. The esophageal variceal pressure in patients with perforating veins was greater than that of patients without perforating veins (23+/- 4.5 vs 12+/-3.1 mmHg, p<0.05). The frequency of endoscopy sessions required for varix eradication and the dots of EVL in patients with perforating veins was greater than that in patients without perforating veins (3.25 +/- 0.50 vs. 2.11+/-.78; 25 +/-.50 vs. 18.56+/- 5.46 p<0.05). The recurrence of esophageal varices within a year was higher in patients with than in patients without perforating veins (75.93 vs. 18.75%, p<0.05).
Perforating veins in the esophageal wall correlate with the recurrence of esophageal varices in patients with portal hypertension
No preview · Article · Jun 2003 · Romanian journal of gastroenterology
[Show abstract][Hide abstract] ABSTRACT: Objective. The noninvasive endoscopic esophageal variceal pressure measurement device was modified and tested for its feasibility and validity. Method. Pressure buffer system was added in an attempt to minimize the inherited pressure fluctuation originating from the milipump plus a pressure handle to control the placement pressure of the improved gauge in order to diminish the variation of tension caused by the physician. The device was tested for its feasibility in in vivo models, and clinical trials in 30 patients with esophageal varices for its validity were performed. Results. The in vivo experiment conducted on dog models and the clinical trials performed in 30 patients showed excellent correlation between the noninvasive device gauge measured and the pressures measured by invasive needle puncture. Conclusion. Although noninvasive measurement in patients with smaller varices warrant further study, the results suggest that noninvasively measured esophageal variceal pressure is valid in the clinical evaluation of patients with larger varices who are at risk of abrupt bleeding.
No preview · Article · Jan 2001 · Romanian journal of gastroenterology