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News

Mucosal abnormalities of cirrhotic small bowel

Mucosal abnormalities in portal jejunopathy include edema, erythema, and vascular lesions findings, and this month's issue of Gastrointestinal Endoscopy proposes a standardized grading system to classify the severity of portal enteropathy.

News image

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The frequency of small-bowel mucosal changes in patients with portal hypertension is not known.

Dr Giovanni Persico and colleagues from Italy defined the mucosal abnormalities of portal hypertensive enteropathy.

The researchers determined whether these findings are associated with the severity of liver disease, esophageal varices, or portal gastropathy.

The research team also determined whether there is an association of these findings with portal colonopathy, or other clinical characteristics.

Lesions included angiodysplastic-like lesions in 24%
Gastrointestinal Endoscopy

The team compared the medical records of 37 patients with cirrhosis and portal hypertension with 34 control patients.

The patients underwent capsule endoscopy over a 3-year period.

Mucosal changes were found to be significantly more common in the cirrhotic patients than in the control patients.

The team noted that the lesions included telangiectasias or angiodysplastic-like lesions in 24% patients, red spots in 62%, and varices in 8%.

The researchers observed active bleeding during endoscopic examinations in 11% of patients.

Comparing patients with and without portal hypertensive enteropathy showed that grade 2 or larger esophageal varices was associated with portal hypertensive enteropathy.

Portal gastropathy, portal colonopathy, and Child-Pugh class C cirrhosis were all significantly associated with portal hypertensive enteropathy.

The research team found no differences between the 2 groups of patients with regard to the etiology of cirrhosis, gender, or history of esophageal variceal bleeding.

Dr Persico's team concluded, “Mucosal abnormalities in portal jejunopathy include edema, erythema, and vascular lesions findings.”

“A standardized grading system to classify the endoscopic appearance and the severity of portal enteropathy is proposed.”

“The clinical import of these changes remains to be explained.”

Gastrointest Endosc 2005: 62(4): 529-34
11 October 2005

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