title: A new method to assess gastric mucosa rewarming time in patients with portal hypertension.
abstract: It is possible that the mucosal damage in congestive gastropathy of portal hypertensive patients may have an ischemic basis, since rewarming time in other sites correlates with local blood flow, a method was designed to assess the capacity of the gastric mucosa to rewarm the stomach after a cold challenge, as an index of ischemia. Eleven control subjects and 15 patients with portal hypertension (10 treated with sclerotherapy) were studied with an integrated circuit temperature transducer connected to a digital display. A balloon containing the temperature transducer inside was reversibly fixed 10 cm. proximally to the distal end of a panendoscope. Once upper endoscopy was completed, the balloon placed in the antrum was infused with cooled water (2 degrees C) through a polyethylene tube. The time elapsed for the water to be rewarmed from 20 degrees C to 25 degrees C to 30 degrees C and 20 degrees C to 30 degrees C was measured. Reproducibility of repeated measurements, gave a coefficient of variation of 6%. Total rewarming time was (-mean +/- SD) 178 +/- 51.3 seconds, significantly higher in Portal hypertensive patients as compared to 114 +/- 34.7 seconds in Controls (P < 0.001). (95% Confidence Interval: -X = 63.4 seconds Cl 45.02 to 81.78). 60% of Sensitivity and 100% of Specificity The slower rewarming time in patients with portal hypertension may be the result of mucosal ischaemia, but oedema and cellular infiltration could also affect the heat flow.
authors.affiliation: Servicio de Gastroenterología, Hospital Italiano de Buenos Aires, Argentina.
authors.forename: L O
authors.initials: LO
authors.lastname: Soifer
authors.forename: J
authors.initials: J
authors.lastname: Olmos
authors.forename: O
authors.initials: O
authors.lastname: Gadea
authors.forename: J
authors.initials: J
authors.lastname: Flores
authors.forename: J
authors.initials: J
authors.lastname: Dávalos
authors.forename: A
authors.initials: A
authors.lastname: de Paula
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D005753:Gastric Mucosa / Q000098:blood supply*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications*; D007511:Ischemia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D017694:Rewarming; D012680:Sensitivity and Specificity; D013997:Time Factors