Oesophageal varices pressure

Oesophageal variceal pressure The size of the oesophageal varices does not correlate with the magnitude of the portal venous pressure, but it does correlate with the oesophageal variceal pressure. This measurement is defined as the difference in pressure between the oesophageal lumen and the varix lumen. Measuring is done by fine-needle aspiration of a varix and the use of an extracorporeal pressure recorder. The procedure is technically simple and reliable ... 

Nevens, F., Sprengers, D., Fevery, J. The effect of different doses of a bolus injection of somatostatin combined with a slow infusion on transmural oesophageal variceal pressure in patients with cirrhosis. J. Hepatol. 1994 20 27-31... 

Tab. 14.9 Haemodynamic and clinical findings in the 5 localized forms of portal hypertension (elevated hepatovenous pressure gradient = > 9 mm Hg increased risk of oesophageal varix bleeding = > 12 mm Hg) (N = normal 0 = not present)...

Metoclopramide reduces the intravaricose pressure by restoring the normal tone to the lower oesophageal sphincter. The use of metoclopramide for the prevention and treatment of oesophageal varix bleeding is thus another pharmacological alternative. The haemodynamic effects of portal hypertension are not influenced. 

Bleeding oesophageal varices may be triggered by three pathogenetic mechanisms (7.) critical pressure increase in the varices, especially when it is sudden (= explosion hypothesis), (2.) occurrence of flow turbulences with bidirectional blood flow in the varices (= circulation hypothesis), and (5.) inflammatory lesion at the varix surface with the formation of thin spots (= erosion hypothesis). 

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