Gastric Polyposis: A Rare Cause of Iron Deficiency Anemia in a Patient With Portal Hypertension

Nagpal, Sajan Jiv Singh; Macaron, Carole; Pai, Rish K.; Alkhouri, Naim

doi:10.14309/crj.2015.14

Cited by 5 publications

(4 citation statements)

References 8 publications

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“…Gastric and duodenal hypertension has been associated with the presence of portal hypertensive polyps, but this has mostly been reported in case reports and a few small case series [ 5 – 10 , 12 – 15 ]. In our study, we comprehensively evaluated the clinical appearance of PHP.…”

Section: Discussionmentioning

confidence: 99%

“…The pathogenic mechanism of PHP remains unknown, but increased congestion caused by increased portal pressure may play an important role in inducing proliferation and angiogenesis. Some observations suggest that these polyps may respond to the treatment of portal hypertension [ 8 – 10 ]. Therefore, the presence of these portal hypertensive polyps may have been particularly high in the present study due to the advanced stage of cirrhosis in our cohort.…”

Section: Discussionmentioning

confidence: 99%

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Portal Hypertensive Polyposis in Advanced Liver Cirrhosis: The Unknown Entity?

Kara

Hüsing‐Kabar

Schmidt

et al. 2018

Canadian Journal of Gastroenterology and Hepatology

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Background Portal hypertension is a serious complication of liver cirrhosis. Objective To identify relevant endoscopic findings in patients with advanced cirrhosis and consecutive portal hypertension. Methods This was a retrospective study of liver transplant candidates who underwent upper gastrointestinal endoscopy between April 2011 and November 2015. Results A total of 1,045 upper endoscopies were analyzed. Portal hypertensive gastric and duodenal polyps were frequently observed and were associated with thrombocytopenia (p = 0.040; OR: 2.4, 95% CI 1.04–5.50), Child-Pugh score > 6 (p = 0.033; OR: 2.3, 95% CI 1.07–4.92), Model for End Stage Liver Disease score > 16 (p = 0.030; OR: 4.1, 95% CI 1.14–15.00), and previous rubber band ligation (p < 0.001; OR = 5.2, 95% CI 2.5–10.7). These polyps often recurred after polypectomy; however, no malignant transformation occurred during the observational time until October 2017. The most common endoscopic finding was esophageal varices, observed in more than 90% of patients. Conclusion Portal hypertensive polyposis is common in patients with advanced cirrhosis. Our data suggest that these polyps have benign characteristics.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Portal Hypertensive Polyposis in Advanced Liver Cirrhosis: The Unknown Entity?

Kara

Hüsing‐Kabar

Schmidt

et al. 2018

Canadian Journal of Gastroenterology and Hepatology

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“…There still needs to be clear diagnostic criteria for PHP. However, typical features of PHP reportedly include foveolar hyperplasia of the epithelium and proliferating ectatic capillaries in the lamina propria; this indicates their portal hypertensive nature and distinguishes them from inflammatory polyps [14]. Most studies did not investigate the risks, such as postpolypectomy bleeding or other complications, and the benefits of endoscopic resection of portal hypertensive polyps or other polyp removal in patients with portal hypertension who presented with bleeding.…”

Section: Original Researchmentioning

confidence: 99%

Gastric Endoscopic Mucosal Resection and Polypectomy among Patients with Liver Cirrhosis and Esophageal Varices in the setting of acute upper gastrointestinal bleeding

Salama

Barakat

sharafeddin

et al. 2023

African Journal of Gastroenterology and Hepatology

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“…PHPs may be responsible for the same symptoms as regular HPs, including pyloric obstruction [20], iron deficiency and anemia [21]. Their prevalence in portal hypertensive and cirrhotic patients is low, from 1% to 8% [17][18][19].…”

Section: Portal Hypertensive Polypsmentioning

confidence: 99%

Differences between sporadic hyperplastic gastric polyps and portal hypertensive gastric polyps: a review

Héroin

Saviano

Fenouil

et al. 2021

European Journal of Gastroenterology &Amp; Hepatology

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Portal hypertension (PH) is one of the most severe complications of chronic liver diseases. It is defined as an increase in pressure in the portal venous system which results in a portosystemic gradient >5 mmHg. In the western world, cirrhosis is the most frequent cause of PH, mainly due to nonalcoholic fatty liver disease and alcoholic liver disease. Patients with PH have esophageal varices in 68-73% of cases, portal hypertensive gastropathy in 51-73% and hyperplastic polyps (HPs) in 0.9-2%. Recent studies have shown that HPs found in PH patients are different from classical HPs. They constitute a new entity called portal hypertensive polyps (PHPs). The main difference between sporadic HPs and PHP is the presence of larger and more numerous vascular capillaries in the lamina propria. The clinical course of PHPs is unknown. Their physiopathology seems different from HPs: the increased congestion caused by higher portal pressure in the stomach may induce capillaries proliferation and neoangiogenesis. PHPs may be responsible for symptoms, such as pyloric obstruction, iron deficiency and anemia. Their prevalence in portal hypertensive and cirrhotic patients is from 1% to 8%. PHPs can be single or numerous, in the antrum or the gastric corpus. Their size ranges from 2 to 3 cm. PHPs seem to disappear or shrink with the treatment of PH. They should be resected in case of symptom and if >10 mm, after Helicobacter pylori eradication if present. However, their recurrence is frequent (40-79%), thus surveillance endoscopy is mandatory, at the same time as esophageal varices. Eur

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Gastric Polyposis: A Rare Cause of Iron Deficiency Anemia in a Patient With Portal Hypertension

Cited by 5 publications

References 8 publications

Portal Hypertensive Polyposis in Advanced Liver Cirrhosis: The Unknown Entity?

Portal Hypertensive Polyposis in Advanced Liver Cirrhosis: The Unknown Entity?

Gastric Endoscopic Mucosal Resection and Polypectomy among Patients with Liver Cirrhosis and Esophageal Varices in the setting of acute upper gastrointestinal bleeding

Differences between sporadic hyperplastic gastric polyps and portal hypertensive gastric polyps: a review

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