Premium
Major predictors of portal hypertensive enteropathy in patients with liver cirrhosis
Author(s) -
Aoyama Taiki,
Oka Shiro,
Aikata Hiroshi,
Igawa Atsushi,
Nakano Makoto,
Naeshiro Noriaki,
Yoshida Shigeto,
Tanaka Shinji,
Chayama Kazuaki
Publication year - 2015
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12658
Subject(s) - medicine , cirrhosis , portal hypertension , gastroenterology , enteropathy , disease
Background and Aim Portal hypertensive enteropathy ( PHE ) is acknowledged as a source of bleeding, and predicting its presence has become more important. We assessed PHE using capsule endoscopy ( CE ) and investigated factors that may predict its presence, including portosystemic shunts ( PSs ). Methods We analyzed data from 134 consecutive patients with liver cirrhosis, from F ebruary 2009 to S eptember 2013. All patients had undergone dynamic computed tomography and esophagogastroduodenoscopy before CE examination. The frequencies and types of PHE lesions, and the relationships between the presence of PHE and patients' clinical characteristics were evaluated. The distribution of the lesions was also determined. Results PHE was found in 91 (68%), erythema in 70 (52%), erosions in 25 (19%), angioectasia in 24 (18%), villous edema in 18 (13%), and varices in 10 (7%) patients. Most lesions were located in the jejunum. The clinical characteristics associated with the presence of PHE were a C hild‐ P ugh grade of B or C ( P = 0.0058), and the presence of PSs ( P < 0.0001), ascites ( P = 0.0017), portal thrombosis ( P = 0.016), esophageal varices ( P = 0.0017), and portal hypertensive gastropathy ( P = 0.0029). The presence of PSs was an independent predictor of PHE (odds ratio [ OR ]: 3.15; 95% confidence interval [ CI ]: 1.27–7.95). Among the shunt types, left gastric vein ( OR : 5.31; 95% CI : 1.97–17.0) and splenorenal shunts ( OR : 4.26; 95% CI : 1.29–19.4) were independent predictors of PHE . Conclusion PSs , especially left gastric vein and splenorenal shunts, appear to reliably predict the presence of PHE .