Document Detail

Characteristic endoscopic features of portal hypertensive enteropathy.
MedLine Citation:
PMID:  18592149     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Double-balloon endoscopy (DBE) and capsule endoscopy have opened up a new field of investigation regarding the small intestine. Although DBE has been widely used for diagnosis and treatment of different lesions in the small intestine, there is a paucity of information regarding endoscopic features of the small intestine in patients with liver cirrhosis (LC). METHODS: Endoscopic images of the small intestine were taken in 21 patients with LC by DBE (EN-450P5/20 or EN-450T5/W). Biopsy specimens were taken from various parts of the small intestine and examined microscopically. Different endoscopic features of the small intestine were compared in relation to the clinical parameters of these patients. RESULTS: Erythema and telangiectasia were observed in five patients (24%) and one patient (5%), respectively. In eight patients (38%), the small intestinal mucosa was edematous, and the intestinal villi of these patients were swollen and rounded, resembling herring roe. The patients with a herring roe appearance in the small intestine had advanced LC (Child's classification B and C), and all of them also had portal hypertensive gastropathy and portal hypertensive colopathy. In comparison with patients without a herring roe appearance in the small intestine, patients with a herring roe appearance had a significantly increased spleen volume (P<0.05) and decreased platelet counts (P<0.05). CONCLUSIONS: Although preliminary, this study indicated that DBE may be useful for detecting different types of endoscopic lesions in patients with LC. A herring roe appearance seems to be one of the characteristic features of portal hypertensive enteropathy. However, further study will be required to develop insights about its pathogenesis.
Naoyuki Higaki; Hidetaka Matsui; Hiroya Imaoka; Yoshiou Ikeda; Hidehiro Murakami; Yoichi Hiasa; Bunzo Matsuura; Morikazu Onji
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-07-01
Journal Detail:
Title:  Journal of gastroenterology     Volume:  43     ISSN:  0944-1174     ISO Abbreviation:  J. Gastroenterol.     Publication Date:  2008  
Date Detail:
Created Date:  2008-07-01     Completed Date:  2008-07-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9430794     Medline TA:  J Gastroenterol     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  327-31     Citation Subset:  IM    
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Toon 791-0295, Japan.
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MeSH Terms
Aged, 80 and over
Diagnosis, Differential
Edema / etiology,  pathology
Endoscopes, Gastrointestinal
Endoscopy, Gastrointestinal / methods*
Equipment Design
Follow-Up Studies
Hypertension, Portal / complications*,  diagnosis
Intestinal Diseases / etiology,  pathology*
Intestinal Mucosa / blood supply,  pathology
Intestine, Small / blood supply,  pathology*
Liver Cirrhosis / complications,  diagnosis
Middle Aged
Reproducibility of Results
Retrospective Studies
Telangiectasis / etiology,  pathology

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