Roentgenological study on esophageal varices:With special reference to factors affecting the contrasting effect on esophagography

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概要

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• To improve the accuracy of diagnosing esophageal varices on x-ray, studies were conducted using various contrast media, drugs for premedication, positions of the body, and roentgenographic techniques.<BR>Based on the data, a barium sulfate of180w/v% with a viscosity of1, 650 c Poise at 25° was most suitable as the contrast medium.<BR>Of the drugs used for premedication, hyoscine-N-butyl bromide (40mg, intravenous injection) significantly enhanced roentgenologic visualization of esophageal varices by inhibiting esophageal peristalsis and relaxing the esophagealwall.<BR>An intravenous injection of hyoscine-N-butyl bromide decreases lower esophageal sphincter pressure (LESP) in a prone much less than in a supine position, competing with the pressure decrease due to the premedication.<BR>A picture taken with the patient head-down in the prone and the first oblique position enableda double contrast image to be taken of the lower and middle esophagus by causingthe barium sulfate to flow from the upper part of the esophagus to the cervical region. This double contrast technique with the patient in the prone and the head-down position using an anticholinergic premedication may be referred to as a hypotonic esophagography.<BR>By using this method, it was possible to diagnose76%of endoscopic Grade I cases and100%of Grade II and III cases with an overall accuracy of91.5%among the129cases of esophageal varices diagnosed by endoscopic method.<BR>These esophageal varices were classified into five categories based on the severity of the lesion, morphology, and size on x-ray examination. This classification is better than that of endoscopy because of its superior objectivity.

• 日本医科大学医学会の論文

日本医科大学医学会 | 論文

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