Portal Hypertensive Enteropathy Diagnosed by Capsule Endoscopy in Cirrhotic Patients: A Nationwide Multicenter Study

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• 作者：Seong Ran Jeon (1)
  Jin-Oh Kim (1)
  Ji-Beom Kim (2)
  Byong Duk Ye (2)
  Dong Kyung Chang (3)
  Ki-Nam Shim (4)
  Dae Young Cheung (5)
  Jin Soo Kim (5)
  Myung Gyu Choi (5)
  Hyun Joo Song (6)
  Yun Jeong Lim (7)
  Soo Jung Park (8)
  Ji Hyun Kim (9)
  Jeong Seop Moon (10)
  Yoon Tae Jeen (11)
  
• 关键词：Capsule endoscopy ; Enteropathy ; Portal hypertension ; Liver cirrhosis
• 刊名：Digestive Diseases and Sciences
• 出版年：2014
• 出版时间：May 2014
• 年：2014
• 卷：59
• 期：5
• 页码：1036-1041
• 全文大小：390 KB
• 参考文献：1. De Palma GD, Rega M, Masone S, et al. Mucosal abnormalities of the small bowel in patients with cirrhosis and portal hypertension: a capsule endoscopy study. / Gastrointest Endosc. 2005;62:529-34. CrossRef
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  3. Kodama M, Uto H, Numata M, et al. Endoscopic characterization of the small bowel in patients with portal hypertension evaluated by double balloon endoscopy. / J Gastroenterol. 2008;43:589-96. CrossRef
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  9. Saurin JC, Delvaux M, Gaudin JL, et al. Diagnostic value of endoscopic capsule in patients with obscure digestive bleeding: blinded comparison with video push-enteroscopy. / Endoscopy. 2003;35:576-84. CrossRef
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  12. McCormack TT, Sims J, Eyre-Brook I, et al. Gastric lesions in portal hypertension: inflammatory gastritis or congestive gastropathy? / Gut. 1985;26:1226-232. CrossRef
  13. Canlas KR, Dobozi BM, Lin S, et al. Using capsule endoscopy to identify GI tract lesions in cirrhotic patients with portal hypertension and chronic anemia. / J Clin Gastroenterol. 2008;42:844-48. CrossRef
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• 作者单位：Seong Ran Jeon (1)
  Jin-Oh Kim (1)
  Ji-Beom Kim (2)
  Byong Duk Ye (2)
  Dong Kyung Chang (3)
  Ki-Nam Shim (4)
  Dae Young Cheung (5)
  Jin Soo Kim (5)
  Myung Gyu Choi (5)
  Hyun Joo Song (6)
  Yun Jeong Lim (7)
  Soo Jung Park (8)
  Ji Hyun Kim (9)
  Jeong Seop Moon (10)
  Yoon Tae Jeen (11)
  
  1. Department of Internal Medicine, Soonchunhyang University College of Medicine, 22 Daesagwan-Gil, Yongsan-Gu, Seoul, 140-743, Korea
  2. Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea
  3. Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
  4. Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
  5. Department of Internal Medicine, The Catholic University College of Medicine, Seoul, Korea
  6. Department of Internal Medicine, Jeju National University School of Medicine, Cheju, Korea
  7. Department of Internal Medicine, Dongguk University College of Medicine, Goyang, Korea
  8. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
  9. Department of Internal Medicine, Inje University College of Medicine, Busan, Korea
  10. Department of Internal Medicine, Inje University College of Medicine, Seoul, Korea
  11. Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
  
• ISSN：1573-2568

文摘

Background and Aim Due to the limited data on portal hypertensive enteropathy (PHE), the prevalence of and clinical factors related to PHE remain unclear. This study determined the prevalence of PHE using capsule endoscopy (CE) and PHE-related clinical factors. Methods This was a retrospective multicenter study using the Capsule Endoscopy Nationwide Database Registry. From 2,879 cases that underwent CE, 45 cirrhosis patients with portal hypertension (PH) were enrolled and divided into PHE (n?=?18) and non-PHE (n?=?27) groups. From computed tomography (CT) images, six secondary changes due to PH were scored to give a total CT score of 0-. The main outcome variable was the prevalence of PHE and PHE-related clinical factors. Results The prevalence of PHE was 40?%. Comparing the PHE and non-PHE groups, the most common findings were angiodysplasias in 55.7?% (vs. 7.4?%, p?=?0.001) and varices in 38.9?% (vs. 0?%, p?=?0.001). Active bleeding was observed in 16.6 and 3.7?%, respectively, but this difference was not significant. In the univariate analysis, Child–Turcotte–Pugh class C (p?=?0.002) and a high CT score (? vs. <3, p?=?0.004) were significantly associated with PHE. However, only a high CT score was significant in the multivariate analysis (odds ratio 11.19; 95?% confidence interval, 1.59-infinity; p?=?0.040). Conclusions The prevalence of PHE was 40?%, and it might be more prevalent in cirrhosis patients with PH who have a high CT score. CE is a useful diagnostic tool for evaluating PHE in cirrhosis patients with PH.