Does modification of portal venous blood flow using balloon-occluded retrograde transvenous obliteration affect the mucosa of the small intestine?

Abstract

Objective: Portal hypertensive enteropathy may be evaluated using capsule endoscopy (CE), but the pathological findings are still unclear. After balloon-occluded retrograde transvenous obliteration (B-RTO), which is usually performed for the treatment of gastric varices and hepatic encephalopathy in patients with liver cirrhosis, occlusion of portosystemic shunts causes an increase in portal blood pressure. This study assessed the effects of this increase on the mucosa of the small intestine. Material and methods:We carried out a retrospective comparison of CE findings in 9 patients with liver cirrhosis who underwent B-RTO. CE was performed preand post-procedure with an interval of 29-52 days and changes in red spot, angioectasia, varices, and inflammatory-like lesions were evaluated. Results:The red spot score increased in 6 patients after B-RTO and was unchanged in 3. The angioectasia score increased in 4 patients and was unchanged in 5. No varices were observed either before or after B-RTO. The score for inflammatory-like lesions increased in 4 patients, remained unchanged in 1 patient, and decreased in 4 patients. The changes in the scores of red spot and angioectasia after B-RTO were statistically significant (p < 0.05). Conclusions:The increase in portal blood pressure caused by B-RTO results in changes in the mucosa of the small intestine.