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Portal shunting in inferior mesenteric vein in cirrhosis: correlation with hemorrhage from esophageal varices.
Am J Gastroenterol. 1994 Jun; 89(6):863-7.AJ

Abstract

OBJECTIVE

Certain patients with portal hypertension develop large esophageal varices, whereas others have small varices, or none. Our objective in this study was to determine whether this variability depends upon the amount of blood derived by peripheral portosystemic collaterals.

METHODS

Esophagogastroscopy to determine presence and size of esophageal varices, and pre-rectal portal scintigraphy to assess portosystemic shunt index (PSI) in inferior mesenteric vein were performed in 45 cirrhotics and 17 patients with pre-cirrhotic liver disease.

RESULTS

Patients with cirrhosis had higher PSI than normal controls (67 +/- 4 vs. 8 +/- 2%; p < 0.0001) and pre-cirrhotic patients (vs. 34 +/- 6%; p < 0.0001). Neither variceal size nor PSI was correlated with Child-Pugh classification or hepatic venous pressure gradient. PSI was not related to the presence of varices or their size. On the other hand, patients with variceal hemorrhage had elevated PSI, compared with non-bleeders (80 +/- 4% vs. 59 +/- 6%; p < 0.005).

CONCLUSIONS

This study shows that portosystemic collaterals in the inferior mesenteric vein do not prevent the formation of large varices. Furthermore, the magnitude of blood flow through peripheral collaterals might reflect the risk of variceal hemorrhage.

Authors+Show Affiliations

Department of Clinical Gastroenterology, Silesian Medical School, Katowice, Poland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8198095

Citation

Hartleb, M, et al. "Portal Shunting in Inferior Mesenteric Vein in Cirrhosis: Correlation With Hemorrhage From Esophageal Varices." The American Journal of Gastroenterology, vol. 89, no. 6, 1994, pp. 863-7.
Hartleb M, Boldys H, Rudzki K, et al. Portal shunting in inferior mesenteric vein in cirrhosis: correlation with hemorrhage from esophageal varices. Am J Gastroenterol. 1994;89(6):863-7.
Hartleb, M., Boldys, H., Rudzki, K., Nowak, A., & Nowak, S. (1994). Portal shunting in inferior mesenteric vein in cirrhosis: correlation with hemorrhage from esophageal varices. The American Journal of Gastroenterology, 89(6), 863-7.
Hartleb M, et al. Portal Shunting in Inferior Mesenteric Vein in Cirrhosis: Correlation With Hemorrhage From Esophageal Varices. Am J Gastroenterol. 1994;89(6):863-7. PubMed PMID: 8198095.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Portal shunting in inferior mesenteric vein in cirrhosis: correlation with hemorrhage from esophageal varices. AU - Hartleb,M, AU - Boldys,H, AU - Rudzki,K, AU - Nowak,A, AU - Nowak,S, PY - 1994/6/1/pubmed PY - 1994/6/1/medline PY - 1994/6/1/entrez SP - 863 EP - 7 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 89 IS - 6 N2 - OBJECTIVE: Certain patients with portal hypertension develop large esophageal varices, whereas others have small varices, or none. Our objective in this study was to determine whether this variability depends upon the amount of blood derived by peripheral portosystemic collaterals. METHODS: Esophagogastroscopy to determine presence and size of esophageal varices, and pre-rectal portal scintigraphy to assess portosystemic shunt index (PSI) in inferior mesenteric vein were performed in 45 cirrhotics and 17 patients with pre-cirrhotic liver disease. RESULTS: Patients with cirrhosis had higher PSI than normal controls (67 +/- 4 vs. 8 +/- 2%; p < 0.0001) and pre-cirrhotic patients (vs. 34 +/- 6%; p < 0.0001). Neither variceal size nor PSI was correlated with Child-Pugh classification or hepatic venous pressure gradient. PSI was not related to the presence of varices or their size. On the other hand, patients with variceal hemorrhage had elevated PSI, compared with non-bleeders (80 +/- 4% vs. 59 +/- 6%; p < 0.005). CONCLUSIONS: This study shows that portosystemic collaterals in the inferior mesenteric vein do not prevent the formation of large varices. Furthermore, the magnitude of blood flow through peripheral collaterals might reflect the risk of variceal hemorrhage. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/8198095/Portal_shunting_in_inferior_mesenteric_vein_in_cirrhosis:_correlation_with_hemorrhage_from_esophageal_varices_ L2 - http://www.diseaseinfosearch.org/result/2658 DB - PRIME DP - Unbound Medicine ER -