Gastrointestinal polypoid lesions: a poorly known endoscopic feature of portal hypertension

Lemmers, Arnaud; Evrard, Sylvie; Demetter, Pieter; Verset, Gontran; Gossum, A. Van; Adler, Michaël; Devière, Jacques; Moine, Olivier Le

doi:10.1177/2050640614529108

Cited by 53 publications

(35 citation statements)

References 17 publications

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“…The authors also reported in this study that the rate of gastric polyps was 10% while the rate of duodenal polyps was 8% with higher rates than those of the normal population when they assessed gastroduodenal polyp frequency [9]. Lemmers et al, on the other hand, reported a rather low rate of portal hypertension-associated polypoid lesions found in the stomach and small intestines in 14 patients (0.9%) in their 1538-patient study [2].…”

Section: Discussionsupporting

confidence: 50%

“…Gastric polyps are lesions that originate from gastric epithelia and grow towards the lumen. They are usually asymptomatic and randomly identified during upper GI endoscopy (EGD) [1,2]. Although portal hypertensive gastropathy in liver cirrhosis is a well-defined finding in EGD in the literature, portal hypertension-associated gastric polyps have not yet been entirely defined.…”

Section: Discussionmentioning

confidence: 99%

“…The pathogenic mechanism of PHP has not been entirely uncovered yet, but some researchers have argued that the congestion brought about by elevated portal pressure might have been playing an important role in inducing proliferation and angiogenesis [2,9,17]. Moreover, it is also possible that mucosal damage, including the vascular structure as well, may be involved in the pathogenesis of portal hypertensionrelated polyps rather than the superficial inflammation of the mucosa [11].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, it is also possible that mucosal damage, including the vascular structure as well, may be involved in the pathogenesis of portal hypertensionrelated polyps rather than the superficial inflammation of the mucosa [11]. In such a case, some observations suggest that these polyps might respond to the treatment of portal hypertension [2,9,17].…”

Section: Discussionmentioning

confidence: 99%

“…Although the exact pathogenesis of PHG is unclear, it is held to mainly involve local or generalized alterations in vascular hemodynamics [1]. In addition to such findings, polypoid lesions in the stomach have rarely been defined as endoscopic findings in patients with liver cirrhosis [2][3][4]. The results of certain studies have revealed that such polypoid formations were characterized histologically by the dilatation in the mucosal and submucosal vessels of the stomach [3,4].…”

Section: Introductionmentioning

confidence: 99%

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Portal Hypertensive Polyps as Gastroscopic Finding in Liver Cirrhosis

Topal

Akbulut

Karahanli

et al. 2020

Gastroenterology Research and Practice

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Background. Portal hypertensive polyps in patients with portal hypertension are described. Aims. The most significant and serious complication in liver cirrhosis proves to be portal hypertension. Polypoid lesions, which can be seen in the stomach as endoscopic finding in patients with portal hypertension, have not quite been defined in the literature. The aim of this study, therefore, was to define polypoid lesion formation due to portal hypertension in the upper gastrointestinal system in patients with portal hypertension. Study Design. Cross-sectional study. Methods. The study covered a group of patients with liver cirrhosis and a healthy control group that did not have portal hypertension. All individuals covered by the study received upper GI endoscopy, while the endoscopic features and pathological characteristics of the identified polypoid lesions were defined. Standard histological criteria were used in polyp diagnosis. Results. A total of 400 individuals were included in the study. Upper GI endoscopy was performed for 200 patients with liver cirrhosis and another 200 healthy individuals with no portal hypertension in the control group. When the cases were gastroscopically assessed with regard to polypoid lesion presence, it was seen that a total of 87 (21.8%) individuals had polyps. While 67 (33.5%) cirrhotic patients were identified to have polyps, 20 (10%) individuals in the healthy control group had polyps. When the results of those with liver cirrhosis who received esophageal variceal endoscopic band ligation (EVL) and who did not were compared, it was observed that a higher number of individuals in the group with EVL had polypoid lesions. When the patient and control groups were compared as to Helicobacter pylori presence, the results showed that it was slightly higher in the dyspepsia group but the difference was not statistically significant (p>0.05). Conclusion. Portal hypertension-associated polypoid lesions are common in advanced liver cirrhosis cases. The pathological analyses of these polyps pointed out that they were all benign and no malignant cases were detected. It was argued that these polypoid lesions, referred to as portal hypertensive polyps, were associated with elevated angiogenesis in the gastric mucosa.

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Section: Discussionsupporting

confidence: 50%

Section: Discussionmentioning

confidence: 99%