PMID: 15250567Jul 15, 2004Paper

Portal hypertensive jejunopathy: a case control study

Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology
Nutan DesaiSucharita Nanivadekar

Abstract

Small bowel mucosa is a recognized potential source of bleeding in portal hypertension. However, the frequency of its involvement is not known. To document the nature, severity and frequency of endoscopic and histologic changes in the jejunum in patients with portal hypertension. Forty consecutive patients with portal hypertension and 43 patients with non-ulcer dyspepsia (controls) underwent push enteroscopy and jejunal, duodenal and gastric biopsies. Biopsies were randomized and examined by a blinded pathologist for inflammation and vascular dilatation, which was quantified by morphometry. Endoscopic jejunopathy was observed in 6 patients and none of the control subjects. All patients with jejunopathy had portal hypertensive gastropathy (PHG) and 5 had duodenopathy. Vascular dilatation was observed in 15 patients and 25 control subjects (p = ns). The degree of vascular dilatation was similar in both groups. Inflammatory changes were observed in 24 patients and 25 control subjects (p = 0.05). Endoscopic jejunopathy was present in 15% of patients with portal hypertension. These changes were mild in 83% of them. All patients with jejunopathy also had PHG. Histologic changes were similar in patients and control subjects.

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