MUCOSAL FINDINGS OF THE SMALL INTESTINE IN PATIENTS WITH PORTAL HYPERTENSION DUE TO LIVER CIRROSIS : A CAPSULE ENDOSCOPY STUDY

DOI 40 References
  • MIZUNO Hideki
    Department of Gastroenterology, Graduate School of Medical Science, Kanazawa University.
  • KAGAYA Takashi
    Department of Gastroenterology, Graduate School of Medical Science, Kanazawa University.
  • OOISHI Naoki
    Department of Gastroenterology, Graduate School of Medical Science, Kanazawa University.
  • TAKATORI Hajime
    Department of Gastroenterology, Graduate School of Medical Science, Kanazawa University.
  • YAMASHITA Tatsuya
    Department of Gastroenterology, Graduate School of Medical Science, Kanazawa University.
  • MIZUKOSHI Eishiro
    Department of Gastroenterology, Graduate School of Medical Science, Kanazawa University.
  • SAKAI Akito
    Department of Gastroenterology, Graduate School of Medical Science, Kanazawa University.
  • NAKAMOTO Yasunari
    Second Department of Internal Medicine, Faculty of Medical Sciences, Fukui University.
  • HONDA Masao
    Department of Gastroenterology, Graduate School of Medical Science, Kanazawa University.
  • KANEKO Shuichi
    Department of Gastroenterology, Graduate School of Medical Science, Kanazawa University.

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Other Title
  • 肝硬変に伴う門脈圧亢進症における小腸病変の検討

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Abstract

Background : Video Capsule endoscopy (VCE) and double-balloon enteroscopy have made it possible to examine most parts of the small intestine. However the mucosal findings of the small intestine in patients with portal hypertension are unknown. The aim of this study was to evaluate the endoscopic features of the small intestine in patients with liver cirrhosis (LC) with VCE. Methods : Between July 2007 and October 2008, 30 patients (LC group ; 15 patients, control group ; 15 patients) were examined with VCE. The relation between endoscopic findings and clinical parameters was compared. Results : Edema, erythema, telangiectasias and angioectasia like lesions were significantly more frequent in the LC group (p<0.05). Lesions classified as vascular lesions were observed in 13 patients (86.7%). In 6 of 15 patients (40.0%), multiple lesions were detected all around the small intestine. The presence of these vascular lesions was not related to esophageal varices, gastric varices, portal hypertensive gastropathy, portal hypertensive colopathy, Child-Pugh class, or combined hepatocellular carcinoma. More patients with this endoscopic pattern had a previous history of varix bleeding (p<0.05). Conclusions : VCE is a safe and useful examination for patients with LC. It is necessary to establish the classification and the clinical significance of the portal hypertensive enteropathy through the accumulation of case data.

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