Studies on the radiographic morphology and manometric motility of the esophagus in patients with portal hypertension. With special reference to the correlation between the extent of esophageal varices and the impaired esophageal function.:with special ref

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A study was conducted to investigate the possible adverse effect of esophageal varices on the morphology and motility of the esophagus in the patients with liver cirrhosis or with idiopathic portal hypertension. Following the esophagography and esophageal endoscopy, 71 patients with portal hypertension were deviled into 4 groups (Grade 0-III) according to the size and extent of the esophageal varices, and subsequently received the esophageal manometry. In parallel with developing grade of esophageal varices, the maximum width of the thoracic esophagus significantly increased, the maximum pressure of the primary peristalsis in the esophageal body significantly decreased, and the Δ transit time of the primary peristaltic wave for the 10cm distance between the middle and the lower esophagus significantly prolonged. In particular, those change as above were found to be marked in all cases with esophageal varices bleeding. On the other hand, both of the upper esophageal sphincter pressure and the lower esophageal sphincter pressure remained unaffected among 4 groups.These findings strongly suggest that the existence of the severe esophageal varices induces the damage to the esophageal function, resulting in the stasis in the lower esophagus, which may cause, at least in part, the rupture of esophageal varices.
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