Measurement of intravariceal pressure by fine needle direct puncture in hepatitis B surface antigen-positive cirrhotic patients: the effect of vasopressin.
The pressure of oesophageal varices was determined by fine needle direct puncture in 19 patients with hepatitis B surface antigen (HBsAg)-positive cirrhosis after the first episode of variceal bleeding before endoscopic sclerotherapy. Both the stability and reliability of the measurement of intravariceal pressure by fine needle puncture were confirmed. Seven patients received intravenous 1 mL normal saline. Intravariceal pressure did not change before and after injection of normal saline (16.3 +/- 4.0 vs 16.0 +/- 4.0 mmHg, P > 0.05). Twelve patients received intravenous 1 units vasopressin and this caused a significant reduction in intravariceal pressure (15.6 +/- 2.6 vs 10.3 +/- 2.9 mmHg, P < 0.0001). The average basal intravariceal pressure in these patients was 15.8 +/- 3.1 mmHg. After intravariceal pressure was recorded, the needle was left in situ and endoscopic sclerotherapy commenced immediately. During the investigation, no adverse reaction or complication was encountered. It was concluded that the measurement of intravariceal pressure by fine needle direct puncture followed by immediate sclerotherapy is a safe and simple method to evaluate the short-term effect of drug prevention from oesophageal variceal bleeding and that vasopressin causes reduction of intravariceal pressure.
Chao
Y
Y
Department of Medicine, Veterans General Hospital-Taipei, Taiwan, ROC.
Wang
S S
SS
Lee
F Y
FY
Lin
H C
HC
Lo
G H
GH
Tsai
Y T
YT
Lee
S D
SD
D000368:Aged; D001794:Blood Pressure / Q000187:drug effects*; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000503:physiopathology; D006514:Hepatitis B Surface Antigens / Q000032:analysis*; D006801:Humans; D007275:Injections, Intravenous; D008103:Liver Cirrhosis / Q000150:complications* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D011677:Punctures; D015911:Sclerotherapy; D014667:Vasopressins / Q000008:administration & dosage*
D006514:Hepatitis B Surface Antigens; D014667:Vasopressins