Abstract
Portal hypertension is a common complication in liver diseases that should be searched for in all cirrhotic patients, as well as in other chronic liver diseases (1). Its main clinical consequence is bleeding from ruptured esophageal or gastric varices, which constitutes the major cause of death and of liver transplantation in patients with cirrhosis, the leading etiology for portal hypertension.
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References
Bolondi L, Gatta A, Groszmann RJ, et al. Baveno II consensus statements: imaging techniques and hemodynamic measurements in portal hypertension. In: De Franchis R, ed. Portal Hypertension II: Proceedings of the Second Baveno International Consensus Workshop on Definitions, Methodology and Therapeutic Strategies. Blackwell Science, Oxford, 1996, p. 67.
Grace ND, Groszmann RJ, Garcia-Tsao G, et al. Portal hypertension and variceal bleeding: an AASLD single topic symposium. Hepatology 1998;28:868–880.
Schepis F, Caimna C, Niceforo D, et al. Which patients with cirrhosis should undergo endoscopic screening for esophageal varices detection? Hepatology 2001;33:333–338.
D’Amico G, Luca A. Natural history. Clinical-hemodynamic correlations. Prediction of the risk of bleeding. Baillieres Clin Gastroenterol 1997;11:243–256.
D’Amico G, García-Tsao G, Calès P, et al. “Diagnosis of portal hypertension, how and when?” portal hypertension III. In: De Franchis R, ed. Proceedings of the Third Baveno International Consensus Workshop on Definitions, Methodology and Therapeutic Strategies. Blackwell Science, Oxford, 2001, pp. 36–63.
De Franchis R. Updating consensus in portal hypertension. Report of the Baveno III consensus workshop on definitions, methodology and therapeutic srategies in portal hypertension. J Hepatol 2000;33:846–852.
D’Amico G. The clinical course of portal hypertension in liver cirrhosis. In: Rossi P, ed. Diagnostic Imaging and Imaging Guided Therapy. Springer-Verlag, Berlin, 2000, pp. 15–24.
Steinlauf AF, Garcia-Tsao G, Zakko MF, Dickey K, Gupta T, Groszmann RJ. Low-dose midazolam sedation: an option for patients undergoing serial hepatic venous pressure measurements. Hepatology 1999;29:1070–1073.
The North Italian Endoscopic Club for the Study and Treatment of Esophageal Varices. Prediction of the first variceal hemorrhage in patients with cirrhosis of the liver and esophageal varices. A prospective multicenter study. N Engl J Med 1988;319:983–989.
Merkel C, Zoli M, Siringo S, et al. Prognostic indicators of risk for first variceal bleeding in cirrhosis: a multicenter study in 711 patients to validate and improve the North Italian Endoscopic Club (NIEC) index. Am J Gastroenterol 2000;95:2915–2920.
Rigau J, Bosch J, Bordas JM, et al. Endoscopic measurement of variceal pressure in cirrhosis: correlation with portal pressure and variceal hemorrhage. Gastroenterology 1989;96:873–880.
Polio J, Groszmann RJ. Hemodynamic factors involved in the development and rupture of esophageal varices: a pathophysiologic approach to treatment. Semin Liver Dis 1986;6:318–331.
Nevens F, Bustami R, Scheys I, Lesaffre E, Fevery J. Variceal pressure is a factor predicting the risk of a first variceal bleeding: a prospective cohort study in cirrhotic patients. Hepatology 1998;27:15–19.
Caletti GC, Brocchi E, Ferrari A, et al. Value of endoscopic ultrasonography in the management of portal hypertension. Endoscopy 1992;24(Suppl l):342–346.
Zoli M, Merkel C, Magalotti D, Marchesini G, Gatta A, Pisi E. Evaluation of a new endoscopic index to predict first bleeding from the upper gastrointestinal tract in patients with cirrhosis. Hepatology 1996;24:1047–1052.
Nevens F, Bustami R, Scheys I, et al. Variceal pressure is a factor predicting the risk of a first variceal bleeding: a prospective cohort study in cirrhotic patients. Hepatology 1998;27:15–19.
El Atti EA, Nevens F, Bogaerts K, Verbeke G, Fevery J. Variceal pressure is a strong predictor of variceal hemorrhage in patients with cirrhosis as well as in patients with non-cirrhotic portal hypertension. Gut 1999;45:618–621.
Groszmann R J. Reassessing portal venous pressure measurements. Gastroenterology 1984;86:1611–1614.
Norton ID, Andrews JC, Kamath PS. Management of ectopic varices. Hepatology 1998;28:1154–1158.
Escorsell A, Bosch J. The pathophysiology of variceal formation and rupture. In: Arroyo V, Bosch J, Bruguera M, Rodé J, eds. Therapy in Liver Diseases. The Pathophysiological Basis of Therapy. Masson, S.A., Barcelona, 1997, pp. 71–79.
Pagliaro L, de Franchis R. Where were we? A summary of the issues where consensus was reached in Baveno T. In: De Franchis, R, ed. Portal Hypertension TI: Proceedings of the Second Baveno International Consensus Workshop on Definitions, Methodology and Therapeutic Strategies. Blackwell Science, Oxford, 1996, pp. 1–9.
Bosch J, Bordas JM, Rigau J, et al. Noninvasive measurement of the pressure of esophageal varices using an endoscopic gauge: comparison with measurements by variceal puncture in patients undergoing endoscopic sclerotherapy. Hepatology 1986;6:667–672.
Mosimann R. Nonaggressive assessment of portal hypertension using endoscopic measurement of variceal pressure. Preliminary report. Am J Surg 1982;143:212–214.
Polio J, Hanson J, Sikuler E, et al. Critical evaluation of a pressure-sensitive capsule for measurement of esophageal varix pressure. Studies in vitro and in canine mesenteric vessels. Gastroenterology 1987;92:1109–1115.
Polio J, Leonard R, Groszmann RJ, et al. An improved pressure-sensitive capsule for endoscopic measurement of esophageal variceal pressure. Dig Dis Sci 1988;33:737–740.
Feu F, Bordas JM, Garcia-Pagan JC, et al. Double-blind investigation of the effects of propranolol and placebo on the pressure of esophageal varices in patients with portal hypertension. Hepatology 1991;13:917–922.
Escorsell A, Bordas JM, Feu F, et al. Endoscopic assessment of variceal volume and wall tension in cirrhotic patients: effects of pharmacological therapy. Gastroenterology 1997;113:1640–1646.
Escorsell A, Feu F, Bordas JM, et al. Effects of isosorbide-5-mononitrate on variceal pressure and systemic and splanchnic hemodynamics in patients with cirrhosis. J Hepatol 1996;24:423–429.
Feu F, Bordas JM, Luca A, et al. Reduction of variceal pressure by propranolol: comparison of the effects on portal pressure and azygos blood flow in patients with cirrhosis. Hepatology 1993;18:1082–1089.
Nevens F, Lijnen P, VanBilloen H, et al. The effect of long-term treatment with spironolactone on variceal pressure in patients with portal hypertension without ascites. Hepatology 1996;23:1047–1052.
Nevens F, Sprengers D, Feu F, et al. Measurement of variceal pressure with an endoscopic pressure sensitive gauge: validation and effect of propranolol therapy in chronic conditions. J Hepatol 1996;24:66–73.
Escorsell A, Bordas JM, Castaneda B, et al. Predictive value of the variceal pressure response to continued pharmacological therapy in patients with cirrhosis and portal hypertension. Hepatology 2000;31:1061–1067.
Brensing KA, Neubrand M, Textor J, et al. Endoscopic manometry of esophageal varices: evaluation of a balloon technique compared with direct portal pressure measurement. J Hepatol 1998;29:94–102.
Gertsch P, Fischer G, Kleber G, et al. Manometry of esophageal varices: comparison of an endoscopic balloon technique with needle puncture. Gastroenterology 1993;105:1159–1166.
Scheurlen C, Roleff A, Neubrand M, et al. Noninvasive endoscopic determination of intravariceal pressure in patients with portal hypertension: clinical experience with a new balloon technique. Endoscopy 1998;30:326–332.
Pontes JM, Leitao MC, Portela F, Nunes A, Freitas D. Endosonographic Doppler-guided manometry of esophageal varices: experimental validation and clinical feasibility. Endoscopy 2002;34:966–972.
Miller ES, Kim JK, Gandehok J, et al. A new device for measuring esophageal variceal pressure. Gastrointest Endosc 2002;56:284–291.
Ueno K, Hashizume M, Ohta M, et al. Noninvasive variceal pressure measurement may be useful for predicting effects of sclerotherapy for esophageal varices. Dig Dis Sci 1996;41:191–196.
Ruiz del Arbol L, Martin de Argila C, Vźquez M, et al. Endoscopic measurement of variceal pressure during hemorrhage from esophageal varices. Hepatology 1992;16:147.
Suzuki T, Matsutani S, Umebara K, et al. EUS changes predictive for recurrence of esophageal varices in patients treated by combined endoscopic ligation and sclerotherapy. Gastrointest Endosc 2000;52:611–617.
Koutsomanis D, Papakonstantinou V. Fractal-assisted EUS image-analysis in the evaluation of variceal eradication after elastic band ligation. Hepatogastroenterology 1999;46:3142–3147.
Burtin P, Cales P, Oberti F, et al. Endoscopic ultrasonographic signs of portal hypertension in cirrhosis. Gastrointest Endosc 1996;44:257–261.
Miller L, Banson FL, Bazir K, et al. Risk of esophageal variceal bleeding based on endoscopic ultrasound evaluation of the sum of esophageal variceal cross-sectional surface area. Am J Gastroenterol 2003;98:454–459.
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© 2005 Humana Press Inc., Totowa, NJ
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Escorsell, À., Bosch, J. (2005). Endoscopic Assessment of Portal Hypertension Including Variceal Pressure Measurements. In: Sanyal, A.J., Shah, V.H. (eds) Portal Hypertension. Clinical Gastroenterology. Humana Press. https://doi.org/10.1007/978-1-59259-885-4_11
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DOI: https://doi.org/10.1007/978-1-59259-885-4_11
Publisher Name: Humana Press
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