THE GASTRIC MUCOSAL BLOOD FLOW IN PATIENT WITH LIVER CIRRHOSIS - SPECIAL REFERENCE TO THE ENDOSCOPIC INJECTION SCLEROTHERAPY AND GASTRIC MUCOSAL LESIONS-

Abstract

In order to elucidate the changes of gastric wall microcirculation in portal hypertension, studies on gastric mucosal blood flow had been undergone by the hydrogen gas clearance methods in cirrhotic patients. Moreover, an attempt to compare gastric lesions with the change of gastric mucosal blood flow was made before and after endoscopk injection sclerotherapy (EIS) for esophageal varices by means of endoscopy, portography and measurement of portal pressure. As a result, gastric mucosal blood flow in cirrhotic patients was increased in comparison to normal subjects, and especially significant difference was recognized in the upper stomach. In addition, increased gastric mucosal blood flow was more remarkable in cirrhotic patients with gastric lesions than those without gastric lesions. After EIS, portal pressure was decreased all cases except one case and gastric mucosal blood flow was significantly decreased in the upper stomach which seemed to relate to reformation of collateral flow seen on portogram. Apparent post-EIS improvement of gastric lesions was found only in one case, but no change in the rest of them and there were none of cases in which gastric lesions became critically severe due to EIS. These results suggest that the decrease of both gastric mcosal blood flow in the upper stomach and portal pressure are due to reformation of collateral flow by EIS, and there is a possibility that gastric mucosal lesions in patient with portal hypertension would be also influenced by EIS.