Document Detail


Portal hypertensive enteropathy before and after variceal obliteration: an endoscopic, histopathologic and immunohistochemical study.
MedLine Citation:
PMID:  20593051     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To study portal hypertensive enteropathy (PHE) before and after the obliteration of esophageal varices.
METHODS: 30 patients with portal hypertension and esophageal varices were included. Band ligation was performed for every patient until the obliteration of esophageal varices. Enteroscopy and biopsies from gastric, duodenal and jejunal mucosa were taken at the beginning of the study and after variceal obliteration. Morphometric measurement of mean vascular areas and estimation of tissue vascular endothelial growth factor (VEGF) were also completed.
RESULTS: The number of patients with enteropathy increased from 6.6% before obliteration to 46.7% after variceal obliteration (p< 0.001). Angiogenesis, vascular ectasia and blood extravasation were the main histopathological findings and all increased significantly after variceal obliteration. The mean vascular area of ectatic vessels in the gastric, duodenal and jejunal biopsies also increased after variceal obliteration. The mean VEGF in the gastric, duodenal and jejunal biopsies increased after variceal obliteration. The mean corpuscular volume (MCV) and hemoglobin (Hb) concentration were significantly lower after variceal obliteration.
CONCLUSION: the portal hypertensive enteropathic changes increased in frequency and severity after esophageal variceal obliteration with a probability of causing anemia.
Authors:
Hisham R El-Khayat; Ahmed El Khattib; Mona Nosseir; Mohamed Aboul Ezz; Hussein El-Amin; Yasser M Fouad
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of gastrointestinal and liver diseases : JGLD     Volume:  19     ISSN:  1841-8724     ISO Abbreviation:  J Gastrointestin Liver Dis     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-07-01     Completed Date:  2010-11-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101272825     Medline TA:  J Gastrointestin Liver Dis     Country:  Romania    
Other Details:
Languages:  eng     Pagination:  175-9     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology, Theodore Bilharz Institute, Cairo, Egypt.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anemia / etiology
Biopsy
Duodenum / pathology
Egypt
Endoscopy, Gastrointestinal*
Esophageal and Gastric Varices / etiology,  metabolism,  pathology,  surgery*
Female
Gastric Mucosa / pathology
Gastrointestinal Hemorrhage / etiology,  metabolism,  pathology,  surgery*
Gastrointestinal Tract / blood supply,  metabolism,  pathology*
Humans
Hypertension, Portal / complications,  metabolism,  pathology,  surgery*
Immunohistochemistry*
Intestinal Mucosa / pathology
Jejunum / pathology
Ligation
Male
Middle Aged
Severity of Illness Index
Treatment Outcome
Vascular Endothelial Growth Factor A / analysis
Chemical
Reg. No./Substance:
0/VEGFA protein, human; 0/Vascular Endothelial Growth Factor A

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