Esophageal varix bleeding due to portal hypertension in liver cirrhotics in very emergency state and difficult for management. In spite of many kinds of treatment in esophageal varix bleeding such as medical and surgical methods, but can't be
expected
of good results. Lebrec report that propranolol is significantly decreased portal venous pressure in 1980. This study analyzed the portal hemodynamics by liver scintigraphy of 38 patients with liver cirrhosis who were proven to have esophageal
varices
and 10 normal subjects. The 19 cirrhotics had taken liver scintigraphy before and after propranolol medication.
There were significant difference in HAI(Hepatic Arterial Index) between cirrhotics and normal subjects(64.7±16.5% vs 31.9±8.3%, p<0.001). There were no significant difference in HAI according to the Child's classification, the type of variceal
morphology and the presence of ascites, but the HAI in Child B(68.1%) and C(63.4%) groups were higher than that in Child A group(55.5%). The heart rate decreased significantly after propranolol(-7.6No./min, p<0.001) and the HAI increased
significantly
after propranolol (+8.0%, p<0.05). It should be suggested that propranolol is effective in decreasing the protal hypertension by decreasing the portal blood flow. There were no serious complication of propranolol.
In conclusion, these results suggest that propranolol could be potentially useful and safe agent in management and prevention of variceal bleeding the portal hypertension and the liver scintigraphy with 99mTc tin colloid is reasonably a accurate,
simple, safe, and rapid method, therefore can be considered suitable for use in the assecement of liver hemodynamics.(Korean J Gastroenterol 1994 ; 26 : 119-126)
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