[Skip to Navigation]
December 18, 1967

Clinical Investigation of the Portacaval Shunt: III. The Diagnosis of Esophageal Varices

Author Affiliations

From the departments of medicine, University of California, Los Angeles (Dr. Dagradi), University of Pittsburgh School of Medicine (Dr. Peternel), University of Miami (Fla) School of Medicine (Dr. Rogers); departments of surgery, University of Puerto Rico School of Medicine, Rio Piedras (Dr. Nadal) and University of Pittsburgh School of Medicine (Dr. Jackson); and the Department of Preventive Medicine, University of Washington School of Medicine, Seattle (Dr. Perrin).

JAMA. 1967;202(12):1081-1084. doi:10.1001/jama.1967.03130250063009

In 83 patients with liver cirrhosis, an esophagogram after administration of barium sulfate, an endoscopic examination of the esophagus, and a portogram after percutaneous injection of an opaque material into the spleen were compared for diagnostic value in demonstrating esophageal varices. The diagnosis was established by esophagoscopy in 81, by splenoportography in 61, and by barium esophagogram in 55. Large varices were frequently missed by barium esophagograms as well as by splenoportograms. The mean splenic-pulp pressure was similar when patients with endoscopically demonstrated varices and normal portograms were compared with those whose portogram showed varices. Moreover, there was no apparent relation between portal pressure and variceal size. A time lapse between studies of as long as two months had no apparent influence on the incidence of positive diagnoses obtained.