RICHARD L. BUTLER, M.D., F.A.C.S.; PETER BYLES, M.D., F.R.C.S.; LAWRENCE PORT, M.D., F.A.C.P.
To the editor: We are reporting five cases in which esophagovariceal bleeding stopped immediately after left artificial pneumothorax, and we suggest that left artificial pneumothorax not only decreases inspiratory negative pressure, which may abet such bleeding, but can tamponade bleeding esophageal varices.
Normal inspiration evacuates extrathoracic veins while filling intrathoracic veins. But strong inspirations collapse intrathoracic veins transiently, closing and distending them and causing flutter flow (1). Air counter-pressure has been shown to overcome transmural bleeding pressure and stop measured bleeding in arterial and venous injuries of limbs (2). Artificial pneumothorax raises and narrows intrathoracic pressures (3). It is safe;
BUTLER RL, BYLES P, PORT L. Pneumothorax for Esophageal Bleeding?. Ann Intern Med. ;78:312–313. doi: 10.7326/0003-4819-78-2-312_2
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Published: Ann Intern Med. 1973;78(2):312-313.
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