An Update

Rockey, Don C.

doi:10.1016/j.cld.2019.07.002

Cited by 28 publications

(7 citation statements)

References 89 publications

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“…Portal hypertensive colopathy (PHC) is a colonic phenomenon commonly causing chronic gastrointestinal bleeding or less commonly a life-threatening acute colonic hemorrhage. Described since 1991, the literature suggests portal and sinusoidal hypertension are essential for developing characteristic macroscopic changes including vascular ectasias, anorectal or colonic varices, hemorrhoids and nonspecific inflammatory [ 1 ]. Microscopically dilatation of capillaries and venues in mucosa and submucosa with or without inflammation are important features but often difficult to observe in histopathology [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…Described since 1991, the literature suggests portal and sinusoidal hypertension are essential for developing characteristic macroscopic changes including vascular ectasias, anorectal or colonic varices, hemorrhoids and nonspecific inflammatory [ 1 ]. Microscopically dilatation of capillaries and venues in mucosa and submucosa with or without inflammation are important features but often difficult to observe in histopathology [ 1 , 2 ]. The underlying causes for these changes reported to date in literature include portal vein thrombosis, schistosomiasis, veno-occlusive disease, cardiac failure and, most notably, liver cirrhosis [ 1 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…Microscopically dilatation of capillaries and venues in mucosa and submucosa with or without inflammation are important features but often difficult to observe in histopathology [ 1 , 2 ]. The underlying causes for these changes reported to date in literature include portal vein thrombosis, schistosomiasis, veno-occlusive disease, cardiac failure and, most notably, liver cirrhosis [ 1 , 3 ]. Liver cirrhosis patients with portal hypertension have the highest prevalence of PHC (20–98%) [ 1 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…The underlying causes for these changes reported to date in literature include portal vein thrombosis, schistosomiasis, veno-occlusive disease, cardiac failure and, most notably, liver cirrhosis [ 1 , 3 ]. Liver cirrhosis patients with portal hypertension have the highest prevalence of PHC (20–98%) [ 1 , 4 ]. Additionally, PHC is often diagnosed following the more well-known and prevalent portal hypertensive gastropathy (PHG), which leads to esophageal varices reflecting advanced cirrhosis.…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, PHC is often diagnosed following the more well-known and prevalent portal hypertensive gastropathy (PHG), which leads to esophageal varices reflecting advanced cirrhosis. [ 1 , 4 ] Medical treatment for both of these conditions includes iron replacement, blood transfusions and portal pressure-reducing agents like octreotide [ 1 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Newly diagnosed cirrhosis secondary to gastrointestinal bleed due to portal hypertensive colopathy

Sabat

Schulze

2023

Journal of Surgical Case Reports

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Portal hypertensive colopathy (PHC) is a colonic phenomenon commonly causing chronic gastrointestinal bleeding or less commonly a life-threatening acute colonic hemorrhage. An otherwise well, 58-year-old female presents general surgeons a diagnostic dilemma for symptomatic anemia. An interesting case where the rare and elusive PHC was diagnosed on colonoscopy, which led to the diagnosis of liver cirrhosis without evidence of oesophageal varices. Although PHC is most common in patients with cirrhosis, it is likely still underdiagnosed, given the current stepwise treatment approach of these cirrhotic patients often leads to treatment of the PHC alongside PHG without establishing a diagnosis. Instead, this case presents a generalised approach to patients with underlying portal and sinusoidal hypertension due to a variety of causes, and the endoscopic and radiological findings, which lead to their successful diagnosis and medical management of the gastrointestinal bleeding.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Newly diagnosed cirrhosis secondary to gastrointestinal bleed due to portal hypertensive colopathy

Sabat

Schulze

2023

Journal of Surgical Case Reports

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Reproductive Health and Liver Disease: Practice Guidance by the American Association for the Study of Liver Diseases

et al. 2021

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Endoscopic ultrasound‐guided portal pressure gradient identifies patients with previously undiagnosed clinically significant portal hypertension

Edelson,

Quiles

et al. 2024

Portal Hypertension & Cirrhosis

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AimsPortal hypertension (PH) is a complication of cirrhosis that leads to hepatic decompensation. Assessing the portal pressure gradient (PPG) provides valuable information for disease assessment, staging, and prognosis. In this study, we aimed to report the utilization of endoscopic ultrasound (EUS)‐guided PPG (EUS‐PPG) measurements in a real‐world setting.MethodsThis retrospective analysis included patients at a tertiary care center who underwent EUS‐PPG between February 2021 and May 2022. The most common indication was to establish or exclude the diagnosis of cirrhosis, followed by an assessment of surgical risk in the setting of suspected cirrhosis. Extensive demographic and clinical data were collected, and statistical analysis was performed using the Student's t test.ResultsEighteen patients underwent EUS‐PPG. Technical success was achieved in 17 of the 18 patients. No complications were observed. The mean scores of Child‐Pugh, Model for End‐Stage Liver Disease‐Sodium, and Fibrosis‐4 scores were 5.1 ± 0.5, 9.0 ± 3.0, and 3.7 ± 4.5, respectively. Of the 18 patients, two presented with esophageal varices and six with portal hypertensive gastropathy. The mean PPG was 5.8 ± 4.5 mmHg, and five patients exhibited clinically significant PH (CSPH). Of the 18 patients, 15 underwent concurrent EUS‐liver biopsy, which was 100% successful and provided diagnostic histology for all patients. The PPG data led to changes in the clinical management of 17 patients.ConclusionsEUS‐PPG is safe and technically feasible. The Child‐Pugh score did not correlate well with the presence of CSPH; however, PPG measurements resulted in changes in the management of almost all patients. Larger studies correlating EUS‐PPG with other assessments of liver diseases are required.

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An Update

Cited by 28 publications

References 89 publications

Newly diagnosed cirrhosis secondary to gastrointestinal bleed due to portal hypertensive colopathy

Newly diagnosed cirrhosis secondary to gastrointestinal bleed due to portal hypertensive colopathy

Reproductive Health and Liver Disease: Practice Guidance by the American Association for the Study of Liver Diseases

Endoscopic ultrasound‐guided portal pressure gradient identifies patients with previously undiagnosed clinically significant portal hypertension

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