Pressure of intraoesophageal varices assessed by fine needle puncture: Its relation to endoscopic signs and severity of liver disease in patients with cirrhosis

Abstract

In 40 patients with cirrhosis and oesophageal varices transmural variceal pressure was assessed endoscopically by fine needle puncture and related to endoscopic signs as well as to the severity of liver disease. Transmural pressure was significantly (p<0·01) higher in the presence of a red colour sign (26·7 (7·8) cm H2O) than in its absence (19·1 (6·6) cm H2O). Transmural pressure, however, was not significantly related to diameter or number of varices (diameter >5 mm: 23-7 (8·4), diameter ≦mm: 22·2 (7·9) cm H2O; number >3:23-2 (8·0), number ≦3:22-2 (7·8) cm H2O). The Child status (Child A: 23·9 (8·0), Child B/C: 21·3 (8·1) cm H2O) and individual Child-Pugh parameters including ascites (ascites present: 23·2 (8·3) cm H2O, ascites absent: 22·8 (8·1) cm H2O) were not significantly related to transmural variceal pressure. We conclude that the endoscopic visibility of a red colour sign on the varices is associated with a high transmural oesophageal variceal pressure. Our results favour the hypothesis that variceal pressure may be of major importance for the development of the red colour sign.