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Evaluation of portal hypertensive enteropathy by scoring with capsule endoscopy: is transient elastography of clinical impact?

Abdelaal UM, Morita E, Nouda S, Kuramoto T, Miyaji K, Fukui H, Tsuda Y, Fukuda A, Murano M, Tokioka S, Arafa UA, Kassem AM, Umegaki E, Higuchi K - J Clin Biochem Nutr (2010)

Bottom Line: We found that the mucosal lesions compatible with PHE were significantly more common in cirrhotic patients than in control patients (67.7% vs 6.9%, p<0.001).Using our scoring system, we found that patients with higher TE score (p = 0.004), high Child-Pugh score (p = 0.011), larger EV (p = 0.006), and prior EIS/EVL (p = 0.006) were significantly associated with higher PHE score.We concluded that using our scoring system might be helpful in grading PHE severity, and TE might be a new non-invasive method for detecting the presence and severity of PHE in cirrhotic patients.

View Article: PubMed Central - PubMed

Affiliation: Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-shi, Osaka 569-8686, Japan.

ABSTRACT
There is limited data about the mucosal lesions of portal hypertensive enteropathy (PHE) detected by capsule endoscopy, and there is no scoring system to evaluate their severity. Our aim is to create a reliable scoring system for PHE, and to explore the possible usefulness of using transient elastograhy (TE) in that field. We compared the medical records of 31 patients with liver cirrhosis and portal hypertension with 29 control patients. We found that the mucosal lesions compatible with PHE were significantly more common in cirrhotic patients than in control patients (67.7% vs 6.9%, p<0.001). Cirrhotic patients with high TE score (p = 0.018), high Child-Pugh grade, large esophageal varices (EV), portal hypertensive gastropathy, and history of endoscopic variceal injection sclerotherapy or ligation (EIS/EVL) were significantly associated with PHE. Using our scoring system, we found that patients with higher TE score (p = 0.004), high Child-Pugh score (p = 0.011), larger EV (p = 0.006), and prior EIS/EVL (p = 0.006) were significantly associated with higher PHE score. We concluded that using our scoring system might be helpful in grading PHE severity, and TE might be a new non-invasive method for detecting the presence and severity of PHE in cirrhotic patients.

No MeSH data available.


Related in: MedlinePlus

Capsule endoscopic views of the vascular lesions of portal hypertensive enteropathy. A: Red spot. B: Angioectasia. C: Serpiginous small bowel varix.
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Figure 1: Capsule endoscopic views of the vascular lesions of portal hypertensive enteropathy. A: Red spot. B: Angioectasia. C: Serpiginous small bowel varix.

Mentions: The mucosal findings detected by the CE in both cirrhotic and control patients are listed in Table 1 (Figs. 1, 2). Twenty-one of the cirrhotic patients (67.7%) were found to have CE signs of PHE; nineteen patients (61.3%) of them had diffuse PHE, and twenty patients (64.5%) had more than one lesion. Active bleeding was seen during endoscopic examination in only one case (3.2%) and was submitted to double balloon endoscopy. On the other side, the mucosal findings were present only in two of the control patients (67.7% vs 6.9%, p<0.001). None of these patients revealed diffuse lesions (61.3% vs 0, p<0.001), and none of them had more than one lesion (64.5% vs 0, p<0.001).


Evaluation of portal hypertensive enteropathy by scoring with capsule endoscopy: is transient elastography of clinical impact?

Abdelaal UM, Morita E, Nouda S, Kuramoto T, Miyaji K, Fukui H, Tsuda Y, Fukuda A, Murano M, Tokioka S, Arafa UA, Kassem AM, Umegaki E, Higuchi K - J Clin Biochem Nutr (2010)

Capsule endoscopic views of the vascular lesions of portal hypertensive enteropathy. A: Red spot. B: Angioectasia. C: Serpiginous small bowel varix.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2901762&req=5

Figure 1: Capsule endoscopic views of the vascular lesions of portal hypertensive enteropathy. A: Red spot. B: Angioectasia. C: Serpiginous small bowel varix.
Mentions: The mucosal findings detected by the CE in both cirrhotic and control patients are listed in Table 1 (Figs. 1, 2). Twenty-one of the cirrhotic patients (67.7%) were found to have CE signs of PHE; nineteen patients (61.3%) of them had diffuse PHE, and twenty patients (64.5%) had more than one lesion. Active bleeding was seen during endoscopic examination in only one case (3.2%) and was submitted to double balloon endoscopy. On the other side, the mucosal findings were present only in two of the control patients (67.7% vs 6.9%, p<0.001). None of these patients revealed diffuse lesions (61.3% vs 0, p<0.001), and none of them had more than one lesion (64.5% vs 0, p<0.001).

Bottom Line: We found that the mucosal lesions compatible with PHE were significantly more common in cirrhotic patients than in control patients (67.7% vs 6.9%, p<0.001).Using our scoring system, we found that patients with higher TE score (p = 0.004), high Child-Pugh score (p = 0.011), larger EV (p = 0.006), and prior EIS/EVL (p = 0.006) were significantly associated with higher PHE score.We concluded that using our scoring system might be helpful in grading PHE severity, and TE might be a new non-invasive method for detecting the presence and severity of PHE in cirrhotic patients.

View Article: PubMed Central - PubMed

Affiliation: Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-shi, Osaka 569-8686, Japan.

ABSTRACT
There is limited data about the mucosal lesions of portal hypertensive enteropathy (PHE) detected by capsule endoscopy, and there is no scoring system to evaluate their severity. Our aim is to create a reliable scoring system for PHE, and to explore the possible usefulness of using transient elastograhy (TE) in that field. We compared the medical records of 31 patients with liver cirrhosis and portal hypertension with 29 control patients. We found that the mucosal lesions compatible with PHE were significantly more common in cirrhotic patients than in control patients (67.7% vs 6.9%, p<0.001). Cirrhotic patients with high TE score (p = 0.018), high Child-Pugh grade, large esophageal varices (EV), portal hypertensive gastropathy, and history of endoscopic variceal injection sclerotherapy or ligation (EIS/EVL) were significantly associated with PHE. Using our scoring system, we found that patients with higher TE score (p = 0.004), high Child-Pugh score (p = 0.011), larger EV (p = 0.006), and prior EIS/EVL (p = 0.006) were significantly associated with higher PHE score. We concluded that using our scoring system might be helpful in grading PHE severity, and TE might be a new non-invasive method for detecting the presence and severity of PHE in cirrhotic patients.

No MeSH data available.


Related in: MedlinePlus