Document Detail

Relationship between directly measured portal pressure gradient and variceal hemorrhage.
MedLine Citation:
PMID:  7485008     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: It is commonly believed that variceal hemorrhage in patients with cirrhosis and portal hypertension does not occur below a portal pressure gradient (PPG) of 12 mm Hg. The aim of this study was to assess the relationship between directly measured portal pressure gradient and variceal hemorrhage. METHODS: The procedure of insertion of the transjugular intrahepatic portosystemic stent-shunt (TIPSS) for variceal hemorrhage provides access to the portal vein and allows direct measurement of the portal pressure. Right atrial, inferior vena caval, and portal pressure were recorded, and the PPG was calculated (portal pressure-inferior vena caval pressure) in 48 patients undergoing TIPSS for variceal hemorrhage. RESULTS: PPG was reduced from a mean of 21.4 (6.4) before TIPSS to 10.6 (3.1) mm Hg after the procedure. Seven patients (14.7%) had a baseline portal pressure gradient of < 12 mm Hg. CONCLUSION: The results of this study do not support the concept of a discrete bleeding threshold.
R Jalan; D N Redhead; E H Forrest; P C Hayes
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  90     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  1995 Nov 
Date Detail:
Created Date:  1995-12-08     Completed Date:  1995-12-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1994-6     Citation Subset:  IM    
Department of Medicine, Royal Infirmary of Edinburgh, United Kingdom.
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MeSH Terms
Atrial Function, Right / physiology
Esophageal and Gastric Varices / etiology,  physiopathology*,  surgery
Gastrointestinal Hemorrhage / etiology,  physiopathology*,  surgery
Liver Cirrhosis / complications
Liver Cirrhosis, Alcoholic / complications
Middle Aged
Portal Pressure / physiology*
Portasystemic Shunt, Surgical / methods
Vena Cava, Inferior / physiopathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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