MUCOSAL FINDINGS OF THE SMALL INTESTINE IN PATIENTS WITH PORTAL HYPERTENSION DUE TO LIVER CIRROSIS : A CAPSULE ENDOSCOPY STUDY

Abstract

Background : Video Capsule endoscopy (VCE) and double-balloon enteroscopy have made it possible to examine most parts of the small intestine. However the mucosal findings of the small intestine in patients with portal hypertension are unknown. The aim of this study was to evaluate the endoscopic features of the small intestine in patients with liver cirrhosis (LC) with VCE. Methods : Between July 2007 and October 2008, 30 patients (LC group ; 15 patients, control group ; 15 patients) were examined with VCE. The relation between endoscopic findings and clinical parameters was compared. Results : Edema, erythema, telangiectasias and angioectasia like lesions were significantly more frequent in the LC group (p<0.05). Lesions classified as vascular lesions were observed in 13 patients (86.7%). In 6 of 15 patients (40.0%), multiple lesions were detected all around the small intestine. The presence of these vascular lesions was not related to esophageal varices, gastric varices, portal hypertensive gastropathy, portal hypertensive colopathy, Child-Pugh class, or combined hepatocellular carcinoma. More patients with this endoscopic pattern had a previous history of varix bleeding (p<0.05). Conclusions : VCE is a safe and useful examination for patients with LC. It is necessary to establish the classification and the clinical significance of the portal hypertensive enteropathy through the accumulation of case data.