Portal hypertensive jejunopathy: a case control study.
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2004-05-15
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Abstract
BACKGROUND: Small bowel mucosa is a recognized potential source of bleeding in portal hypertension. However, the frequency of its involvement is not known. AIMS: To document the nature, severity and frequency of endoscopic and histologic changes in the jejunum in patients with portal hypertension.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: 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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Desai N, Desai D, Pethe V, Deodhar KP, Sawant P, Nanivadekar S. Portal hypertensive jejunopathy: a case control study. Indian Journal of Gastroenterology. 2004 May-Jun; 23(3): 99-101