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Do Alterations in the Rate of Gastric Emptying after Injection Sclerotherapy for Oesophageal Varices Play any Role in the Development of Portal Hypertensive Gastropathy?

Bleeding from portal hypertensive gastropathy (PHG) has been estimated to account for upto 30% of all upper gastrointestinal haemorrhage in patients with cirrhosis and portal hypertension. Although portal hypertension seems to be an essential prerequisite, the precise mechanisms responsible for the...

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Autores principales: Balan, K. K., Grime, J. S., Sutton, R., Critchley, M., Jenkins, S. A.
Formato: Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 1999
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2423968/
https://www.ncbi.nlm.nih.gov/pubmed/10371058
http://dx.doi.org/10.1155/1999/27037
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author Balan, K. K.
Grime, J. S.
Sutton, R.
Critchley, M.
Jenkins, S. A.
author_facet Balan, K. K.
Grime, J. S.
Sutton, R.
Critchley, M.
Jenkins, S. A.
author_sort Balan, K. K.
collection PubMed
description Bleeding from portal hypertensive gastropathy (PHG) has been estimated to account for upto 30% of all upper gastrointestinal haemorrhage in patients with cirrhosis and portal hypertension. Although portal hypertension seems to be an essential prerequisite, the precise mechanisms responsible for the development of PHG are unknown. The aim of this study was to examine the role of injection sclerotherapy of oesophageal varices in the development of PHG. Gastric emptying was studied using a radionuclide test meal with the emptying characteristics of a slow liquid in 57 patients with cirrhosis and/or portal hypertension (median age 53 yrs), of whom 34 had received injection sclerotherapy for their oesophageal varices and 20 normal healthy volunteers (median age 42 yrs). As vagal damage is associated with more rapid emptying of liquids, despite hold up of solids, this technique might be expected to demonstrate such damage if gastric emptying was accelerated. The results indicated that there was no difference in the rate of gastric emptying between normal healthy volunteers and portal hypertensive patients. However, patients who had received injection sclerotherapy emptied their stomachs faster than those who had not (p<0.05). Furthermore, the speed of gastric emptying correlated directly with the number of injections (r=0.41; p=0.02) and the volume of sclerosant injected (r=0.39; p=0.03). These observations suggest that injection sclerotherapy for oesophageal varices results in disturbances of gastric emptying that may contribute to the pathogenesis of portal hypertensive gastropathy.
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spelling pubmed-24239682008-07-08 Do Alterations in the Rate of Gastric Emptying after Injection Sclerotherapy for Oesophageal Varices Play any Role in the Development of Portal Hypertensive Gastropathy? Balan, K. K. Grime, J. S. Sutton, R. Critchley, M. Jenkins, S. A. HPB Surg Research Article Bleeding from portal hypertensive gastropathy (PHG) has been estimated to account for upto 30% of all upper gastrointestinal haemorrhage in patients with cirrhosis and portal hypertension. Although portal hypertension seems to be an essential prerequisite, the precise mechanisms responsible for the development of PHG are unknown. The aim of this study was to examine the role of injection sclerotherapy of oesophageal varices in the development of PHG. Gastric emptying was studied using a radionuclide test meal with the emptying characteristics of a slow liquid in 57 patients with cirrhosis and/or portal hypertension (median age 53 yrs), of whom 34 had received injection sclerotherapy for their oesophageal varices and 20 normal healthy volunteers (median age 42 yrs). As vagal damage is associated with more rapid emptying of liquids, despite hold up of solids, this technique might be expected to demonstrate such damage if gastric emptying was accelerated. The results indicated that there was no difference in the rate of gastric emptying between normal healthy volunteers and portal hypertensive patients. However, patients who had received injection sclerotherapy emptied their stomachs faster than those who had not (p<0.05). Furthermore, the speed of gastric emptying correlated directly with the number of injections (r=0.41; p=0.02) and the volume of sclerosant injected (r=0.39; p=0.03). These observations suggest that injection sclerotherapy for oesophageal varices results in disturbances of gastric emptying that may contribute to the pathogenesis of portal hypertensive gastropathy. Hindawi Publishing Corporation 1999-04 /pmc/articles/PMC2423968/ /pubmed/10371058 http://dx.doi.org/10.1155/1999/27037 Text en Copyright © 1999 Hindawi Publishing Corporation. http://creativecommons.org/licenses/by/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Balan, K. K.
Grime, J. S.
Sutton, R.
Critchley, M.
Jenkins, S. A.
Do Alterations in the Rate of Gastric Emptying after Injection Sclerotherapy for Oesophageal Varices Play any Role in the Development of Portal Hypertensive Gastropathy?
title Do Alterations in the Rate of Gastric Emptying after Injection Sclerotherapy for Oesophageal Varices Play any Role in the Development of Portal Hypertensive Gastropathy?
title_full Do Alterations in the Rate of Gastric Emptying after Injection Sclerotherapy for Oesophageal Varices Play any Role in the Development of Portal Hypertensive Gastropathy?
title_fullStr Do Alterations in the Rate of Gastric Emptying after Injection Sclerotherapy for Oesophageal Varices Play any Role in the Development of Portal Hypertensive Gastropathy?
title_full_unstemmed Do Alterations in the Rate of Gastric Emptying after Injection Sclerotherapy for Oesophageal Varices Play any Role in the Development of Portal Hypertensive Gastropathy?
title_short Do Alterations in the Rate of Gastric Emptying after Injection Sclerotherapy for Oesophageal Varices Play any Role in the Development of Portal Hypertensive Gastropathy?
title_sort do alterations in the rate of gastric emptying after injection sclerotherapy for oesophageal varices play any role in the development of portal hypertensive gastropathy?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2423968/
https://www.ncbi.nlm.nih.gov/pubmed/10371058
http://dx.doi.org/10.1155/1999/27037
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