Gastrointestinal Bleeding Secondary to Portal Hypertensive Duodenopathy in a Patient with Decompensated Liver Cirrhosis

Krishna, Rohini; Igbinedion, Samuel; Diaz, Richie; Hussain, Nazneen; Boktor, Moheb

doi:10.1155/2018/9430701

Cited by 1 publication

(1 citation statement)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…11,12 When studying this pathology, the authors used the terms "portal hypertension duodeno-enteropathy and colonopathy". [12][13][14][15] They observed clinically significant portal colonopathy in 42% of patients with hepatic cirrhosis in the form of edema and atrophy of the intestinal mucosa (in 95% of patients), vasodilatation, and thickening of the walls (in 100%). 16 In addition, it has been proven that severe portal hypertension led to microbiota disturbance, resulting in oxidative stress, which is the cause of anemia, inflammation of the abdominal aorta, spontaneous bacterial peritonitis, and hepatic encephalopathy.…”

Section: Discussionmentioning

confidence: 99%

<p>Increases in Autoantibody Level Associated with Degenerative Changes in the Intestinal Mucosa in Liver Cirrhosis</p>

Karpova¹,

Russkova²,

Lavrentieva³

2020

CEG

View full text Add to dashboard Cite

Background: Portal hypertensive colonopathy is a consequence of portal hypertension that develops in hepatic cirrhosis. Pathological processes occurring in intestinal epithelium cells can be revealed by changes in the autoantibody titers to intestinal antigens. It is important both in diagnosis and in the evaluation of the treatment effectiveness. Purpose: To investigate the effect of portal hypertension in patients with liver cirrhosis on degenerative processes in the walls of the small and large intestines after stimulation of liver regeneration with cryoprecipitate. Methods: Thirty-six patients with liver cirrhosis underwent a procedure for percutaneous introduction of cryoprecipitate into the liver tissue. Before and 1 year after it, all the patients were measured for portal blood flow parameters, performed colonoscopy with biopsy, and determined autoantibodies to intestinal antigens (ItM, SCM) in the blood. Comparative analyses of changes in the large intestine mucosa before and after reducing portal hypertension by stimulating liver regeneration with cryoprecipitate were conducted. Results: Here, we show that the degenerative process in the mucosa of the intestines increases, despite the positive dynamics of portal blood flow parameters after the liver regeneration. Autoantibodies values for the intestine antigens were higher than normal in 22 of the 36 patients after 1 year of introduction of cryoprecipitate into the liver. Morphological analysis of the intestinal wall showed the presence of edema/mucosal atrophy and neutrophilic/lymphocytic-histiocytic infiltration in 28 of the 36 patients. Conclusion: Changes in autoantibodies to intestinal antigens are an informative method for diagnosing colonopathy and enteropathy at early stages, providing the possibility to administer proper timely treatment. Patients with hepatic cirrhosis are recommended to have their intestinal microflora tested and be administered drugs that improve their composition.

show abstract