Pharmacologic influence on esophageal varices: a preliminary report

Selective catheterization of the left gastric vein was performed after percutaneous transhepatic portography (PTP) in patients with portal hypertension and esophageal varices. Following the hypothesis that drugs increasing the lower esophageal sphincter (LES) pressure may obstruct the variceal blood...

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Bibliographic Details
Published in:Cardiovascular and interventional radiology 1983-01, Vol.6 (2), p.65-71
Main Authors: Lunderquist, A, Alwmark, A, Gullstrand, P, Hall-Angeras, M, Joelsson, B, Owman, T, Pettersson, K I, Tranberg, K G
Format: Article
Language:English
Subjects:
Adult
Domperidone - pharmacology
Esophageal and Gastric Varices - complications
Esophageal and Gastric Varices - physiopathology
Esophagogastric Junction - drug effects
Esophagogastric Junction - physiopathology
Humans
Hypertension, Portal - complications
Hypertension, Portal - diagnostic imaging
Hypertension, Portal - physiopathology
Male
Middle Aged
Pentagastrin - pharmacology
Radiography
Regional Blood Flow - drug effects
Somatostatin - pharmacology
Vasopressins - pharmacology
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Summary:Selective catheterization of the left gastric vein was performed after percutaneous transhepatic portography (PTP) in patients with portal hypertension and esophageal varices. Following the hypothesis that drugs increasing the lower esophageal sphincter (LES) pressure may obstruct the variceal blood flow through the lower esophagus, the effect of different drugs (i.e., intravenous injection of vasopressin, pentagastrin, domperidone and somatostatin and subcutaneous injection of metacholine) on the variceal blood flow was examined. Vasopressin did not change the variceal blood flow; pentagastrin, with its known effect of increasing the LES pressure produced a total interruption of the flow in four of eight patients; domperidone, also known to increase the LES pressure obstructed the variceal blood flow in the only patient examined with this drug; somatostatin has no reported action on the LES but blocked the flow in one of two patients; and metacholine, reported to increase the LES pressure did not produce any change in the flow in the three patients examined. LES pressure was recorded before and during vasopressin infusion in seven patients with portal hypertension and esophageal varices. No reaction on the pressure was found. The patient number in the study is small and the results are nonuniform but still they suggest that drugs increasing the LES tonus might be useful to control variceal blood flow.
ISSN:0174-1551
1432-086X
DOI:10.1007/BF02552774