A COMPARATIVE STUDY OF PORTAL VEIN PRESSURE AND ENDOSCOPIC FINDINGS OF ESOPHAGEAL VARICES IN 50 CASES OF LIVER CIRRHOSIS

Abstract

Portal pressures were measured by the method of percutaneous transhepatic portal catheterization (PTPC) in 50 cases of liver cirrhosis, and a comparative study was carried out between levels of portal pressure and endoscopic findings of esophageal varices.
The mean value of portal pressures of 39 cirrhotic patients with esophageal varices was significantly higher than that of 11 cirrhotics without esophageal varices (P<0.005). Esophageal varices trended to extend their localization and intensify their features such as engorgement and tortuosity in accordance with increase of portal pressure. Any definite correlation, however, was hardly observed between color tone of the varices and portal pressures.
Out of 39 cirrhotic patients with esophageal verices, portal pressure of 5 patients with confirmed history of pervious rupture of esophageal varices were obviously higher than that of 34 remaining patients without any history of rupture (P<0.1). Esophageal varices in 5 patients with history of rupture were all classified in Stage III, according to the endoscopical criteria proposed by surgical society for the study of the portal venous system. In other expression, bleeding from esophageal varices was observed in 5 cases (71.4%) out of 7 cirrhotic patients both with esophageal varices of Stage III and portal pressures of over 325 mm H₂O.
Those results suggest that measurement of portal pressure by percutaneous transhepatic portal catheterization (PTPC) would give some contributory informations, besides endoscopic findings, for anticipation of possible rupture and indication for prophylactic surgery for cirrhotic patients with esophageal varices.