{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T16:51:00Z","timestamp":1773939060469,"version":"3.50.1"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2002,10,1]],"date-time":"2002-10-01T00:00:00Z","timestamp":1033430400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2003,12,30]],"date-time":"2003-12-30T00:00:00Z","timestamp":1072742400000},"content-version":"vor","delay-in-days":455,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Fondo de Investigaci\u00f3n de la Seguridad Social","award":["FIS 99\/0362"],"award-info":[{"award-number":["FIS 99\/0362"]}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2002,10]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>Many daily activities cause acute elevations of intra-abdominal pressure (IAP). In portal hypertensive cirrhotic patients, increased IAP increases absolute portal pressure and azygos blood flow, suggesting that it may have detrimental consequences at the esophageal varices. The aim of this study was to investigate the effects of increased IAP on variceal pressure, size, and wall tension. Endosonography and a noninvasive endoscopic pressure gauge were used to measure variceal pressure, radius, wall tension, and volume in baseline conditions and after increasing IAP by 10 mm Hg using an inflatable girdle in 14 patients with cirrhosis and esophageal varices. Increasing IAP markedly increased variceal pressure (from 13.3 \u00b1 4.2 to 17.4 \u00b1 4.6 mm Hg; <jats:italic toggle=\"yes\">P<\/jats:italic> = .0001) and radius (from 2.9 \u00b1 1.0 to 3.9 \u00b1 1.1 mm; <jats:italic toggle=\"yes\">P<\/jats:italic> = .0001). Consequently, wall tension dramatically increased (from 38.7 \u00b1 13.6 to 65.9 \u00b1 23.8 mm Hg \u00b7 mm, +78%; <jats:italic toggle=\"yes\">P<\/jats:italic> = .0001). Variceal volume increased significantly from 1,264 \u00b1 759 to 2,025 \u00b1 1,129 mm<jats:sup>3<\/jats:sup> (<jats:italic toggle=\"yes\">P<\/jats:italic> = .0001). In conclusion, in portal hypertensive cirrhotic patients, increases in IAP have deleterious effects on variceal hemodynamics, markedly increasing the volume, pressure, and wall tension of the varices. Increases in IAP may contribute to the progressive dilatation that precedes the rupture of the varices in portal hypertension.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1053\/jhep.2002.35817","type":"journal-article","created":{"date-parts":[[2003,3,26]],"date-time":"2003-03-26T02:15:53Z","timestamp":1048644953000},"page":"936-940","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":44,"title":["Increasing intra-abdominal pressure increases pressure, volume, and wall tension in esophageal varices"],"prefix":"10.1097","volume":"36","author":[{"given":"Angels","family":"Escorsell","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angels","family":"Gin\u00e8s","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josep","family":"Llach","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joan C.","family":"Garc\u00eda-Pag\u00e1n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josep M.","family":"Bordas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaume","family":"Bosch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joan","family":"Rod\u00e9s","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"10.1053\/jhep.2002.35817-BIB1|cit1","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1055\/s-2008-1040614","article-title":"Hemodynamic factors involved in the development and rupture of esophageal varices: a pathophysiologic approach to treatment","volume":"6","author":"Polio","year":"1986","journal-title":"Semin Liver Dis"},{"key":"10.1053\/jhep.2002.35817-BIB2|cit2","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1016\/S0016-5085(89)80090-3","article-title":"Endoscopic measurement of variceal pressure in cirrhosis: correlation with portal pressure and variceal 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