Document Detail

Effect of portal hypertension in the small bowel: an endoscopic approach.
MedLine Citation:
PMID:  18026837     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND AIM: The effects of portal hypertension in the small bowel are largely unknown. The aim of the study was to prospectively assess portal hypertension manifestations in the small bowel. METHODS: We compared, by performing enteroscopy with capsule endoscopy, the endoscopic findings of 36 patients with portal hypertension, 25 cirrhotic and 11 non-cirrhotic, with 30 controls. RESULTS: Varices, defined as distended, tortuous, or saccular veins, and areas of mucosa with a reticulate pattern were significantly more frequent in patients with PTH. These two findings were detected in 26 of the 66 patients (39%), 25 from the group with PTH (69%) and one from the control group (3%) (P < 0.0001). Among the 25 patients with PTH exhibiting these patterns, 17 were cirrhotic and 8 were non-cirrhotic (P = 0.551). The presence of these endoscopic changes was not related to age, gender, presence of cirrhosis, esophageal or gastric varices, portal hypertensive gastropathy, portal hypertensive colopathy, prior esophageal endoscopic treatment, current administration of beta-blockers, or Child-Pugh Class C. More patients with these endoscopic patterns had a previous history of acute digestive bleeding (72% vs. 36%) (P = 0.05). Active bleeding was found in two patients (5.5%). CONCLUSIONS: The presence of varices or areas of mucosa with a reticulate pattern are manifestations of portal hypertension in the small bowel, found in both cirrhotic and non-cirrhotic patients. The clinical implications of these findings, as regards digestive bleeding, are uncertain, although we documented acute bleeding from the small bowel in two patients (5.5%).
Pedro Figueiredo; Nuno Almeida; Clotilde Lérias; Sandra Lopes; Hermano Gouveia; Maximino C Leitão; Diniz Freitas
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Publication Detail:
Type:  Journal Article     Date:  2007-11-17
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  53     ISSN:  0163-2116     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-02     Completed Date:  2008-08-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2144-50     Citation Subset:  AIM; IM    
Department of Gastroenterology, Hospitais da Universidade de Coimbra, Coimbra, Portugal.
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MeSH Terms
Aged, 80 and over
Capsule Endoscopy*
Case-Control Studies
Endoscopy, Gastrointestinal / methods*
Gastrointestinal Hemorrhage / etiology*,  pathology
Hypertension, Portal / complications*,  pathology
Intestinal Diseases / etiology*,  pathology
Intestinal Mucosa / pathology
Intestine, Small / blood supply*,  pathology*
Middle Aged
Prospective Studies
Varicose Veins / etiology*,  pathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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