Skip to main content
PMC home page
Gut logoLink to Gut
. 1993 May;34(5):694–697. doi: 10.1136/gut.34.5.694

Congestive jejunopathy in portal hypertension.

A S Nagral 1, A S Joshi 1, S J Bhatia 1, P Abraham 1, F P Mistry 1, I M Vora 1
PMCID: PMC1374192  PMID: 8504973

Abstract

Twenty six patients with portal hypertension of different aetiologies were studied for endoscopic evidence of congestive gastroduodenopathy and histological evidence of congestive gastropathy and jejunopathy. Per oral biopsies of jejunum were taken by Watson's capsule. Normal biopsy tissues obtained from the antrum (26), fundus (10), and jejunum (26) were used as controls. Endoscopy showed congestive changes in the fundus (17 cases), antrum (17), and duodenum (4). Duodenopathy correlated with changes in the antrum but not in the fundus. Histology showed an increase in the size and number of vessels in the jejunal villi ('congestive jejunopathy') in 22 patients. These correlated with histological evidence of gastropathy in the fundus but not in the antrum. The incidence of congestive jejunopathy did not correlate with the Child-Pugh score in patients with cirrhosis or with the number of sclerotherapy sessions received. Congestive jejunopathy is part of the spectrum of congestive gastroenteropathy and occurs at least as frequently as changes in the stomach and duodenum. The clinical import of these jejunal changes remains to be explained.

Full text

PDF
694

Images in this article

696Figure 1
on p.696
696Figure 2
on p.696

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Calès P., Zabotto B., Meskens C., Caucanas J. P., Vinel J. P., Desmorat H., Fermanian J., Pascal J. P. Gastroesophageal endoscopic features in cirrhosis. Observer variability, interassociations, and relationship to hepatic dysfunction. Gastroenterology. 1990 Jan;98(1):156–162. [PubMed] [Google Scholar]
  2. D'Amico G., Montalbano L., Traina M., Pisa R., Menozzi M., Spanò C., Pagliaro L. Natural history of congestive gastropathy in cirrhosis. The Liver Study Group of V. Cervello Hospital. Gastroenterology. 1990 Dec;99(6):1558–1564. doi: 10.1016/0016-5085(90)90458-d. [DOI] [PubMed] [Google Scholar]
  3. Franco D., Durandy Y., Deporte A., Bismuth H. Upper gastrointestinal haemorrhage in hepatic cirrhosis: causes and relation to hepatic failure and stress. Lancet. 1977 Jan 29;1(8005):218–220. doi: 10.1016/s0140-6736(77)91015-7. [DOI] [PubMed] [Google Scholar]
  4. Hosking S. W., Kennedy H. J., Seddon I., Triger D. R. The role of propranolol in congestive gastropathy of portal hypertension. Hepatology. 1987 May-Jun;7(3):437–441. doi: 10.1002/hep.1840070304. [DOI] [PubMed] [Google Scholar]
  5. Kozarek R. A., Botoman V. A., Bredfeldt J. E., Roach J. M., Patterson D. J., Ball T. J. Portal colopathy: prospective study of colonoscopy in patients with portal hypertension. Gastroenterology. 1991 Nov;101(5):1192–1197. doi: 10.1016/0016-5085(91)90067-u. [DOI] [PubMed] [Google Scholar]
  6. Lebrec D., De Fleury P., Rueff B., Nahum H., Benhamou J. P. Portal hypertension, size of esophageal varices, and risk of gastrointestinal bleeding in alcoholic cirrhosis. Gastroenterology. 1980 Dec;79(6):1139–1144. [PubMed] [Google Scholar]
  7. McCormack T. T., Sims J., Eyre-Brook I., Kennedy H., Goepel J., Johnson A. G., Triger D. R. Gastric lesions in portal hypertension: inflammatory gastritis or congestive gastropathy? Gut. 1985 Nov;26(11):1226–1232. doi: 10.1136/gut.26.11.1226. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. McCormick P. A., Sankey E. A., Cardin F., Dhillon A. P., McIntyre N., Burroughs A. K. Congestive gastropathy and Helicobacter pylori: an endoscopic and morphometric study. Gut. 1991 Apr;32(4):351–354. doi: 10.1136/gut.32.4.351. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Mistry F. P., Karnad D. R., Abraham P., Bhatia S. J. A scoring system to differentiate cirrhotic from non-cirrhotic portal hypertension. Indian J Gastroenterol. 1991 Jul;10(3):82–85. [PubMed] [Google Scholar]
  10. Papazian A., Braillon A., Dupas J. L., Sevenet F., Capron J. P. Portal hypertensive gastric mucosa: an endoscopic study. Gut. 1986 Oct;27(10):1199–1203. doi: 10.1136/gut.27.10.1199. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Pugh R. N., Murray-Lyon I. M., Dawson J. L., Pietroni M. C., Williams R. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg. 1973 Aug;60(8):646–649. doi: 10.1002/bjs.1800600817. [DOI] [PubMed] [Google Scholar]
  12. Pérez-Ayuso R. M., Piqué J. M., Bosch J., Panés J., González A., Pérez R., Rigau J., Quintero E., Valderrama R., Viver J. Propranolol in prevention of recurrent bleeding from severe portal hypertensive gastropathy in cirrhosis. Lancet. 1991 Jun 15;337(8755):1431–1434. doi: 10.1016/0140-6736(91)93125-s. [DOI] [PubMed] [Google Scholar]
  13. Quintero E., Pique J. M., Bombi J. A., Bordas J. M., Sentis J., Elena M., Bosch J., Rodes J. Gastric mucosal vascular ectasias causing bleeding in cirrhosis. A distinct entity associated with hypergastrinemia and low serum levels of pepsinogen I. Gastroenterology. 1987 Nov;93(5):1054–1061. doi: 10.1016/0016-5085(87)90569-5. [DOI] [PubMed] [Google Scholar]
  14. Rector W. G., Jr, Reynolds T. B. Risk factors for haemorrhage from oesophageal varices and acute gastric erosions. Clin Gastroenterol. 1985 Jan;14(1):139–153. [PubMed] [Google Scholar]
  15. Sarfeh I. J., Soliman H., Waxman K., Coccia M., Rypins E. B., Bui H. X., Tarnawski A. Impaired oxygenation of gastric mucosa in portal hypertension. The basis for increased susceptibility to injury. Dig Dis Sci. 1989 Feb;34(2):225–228. doi: 10.1007/BF01536055. [DOI] [PubMed] [Google Scholar]
  16. Tabibian N., Graham D. Y. Source of upper gastrointestinal bleeding in patients with esophageal varices seen at endoscopy. J Clin Gastroenterol. 1987 Jun;9(3):279–282. doi: 10.1097/00004836-198706000-00007. [DOI] [PubMed] [Google Scholar]
  17. Tarnawski A. S., Sarfeh I. J., Stachura J., Hajduczek A., Bui H. X., Dabros W., Gergely H. Microvascular abnormalities of the portal hypertensive gastric mucosa. Hepatology. 1988 Nov-Dec;8(6):1488–1494. doi: 10.1002/hep.1840080604. [DOI] [PubMed] [Google Scholar]
  18. Terés J., Bordas J. M., Bru C., Diaz F., Bruguera M., Rodes J. Upper gastrointestinal bleeding in cirrhosis: clinical and endoscopic correlations. Gut. 1976 Jan;17(1):37–40. doi: 10.1136/gut.17.1.37. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Thiruvengadam R., Gostout C. J. Congestive gastroenteropathy--an extension of nonvariceal upper gastrointestinal bleeding in portal hypertension. Gastrointest Endosc. 1989 Nov-Dec;35(6):504–507. doi: 10.1016/s0016-5107(89)72898-4. [DOI] [PubMed] [Google Scholar]
  20. Whitehead R., Truelove S. C., Gear M. W. The histological diagnosis of chronic gastritis in fibreoptic gastroscope biopsy specimens. J Clin Pathol. 1972 Jan;25(1):1–11. doi: 10.1136/jcp.25.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES