Portal Hypertensive Colopathy: Endoscopic Findings and the Relation to Portal Pressure.

Abstract

Portal hypertensive colopathy (PHC) is a newclinical entity in patients with liver cirrhosis. In this study, colonoscopic findings and clinical features including upper gastrointestinal endoscopy and hepatic hemodynamics were prospectively investigated among 35 PH patients with a hepatic venous pressure gradient (HVPG) of greater than 12 mmHgdue to chronic liver diseases. Colonoscopy was also performed in 100 patients without liver disease as non-PH controls. The colonoscopy revealed vascular ectasias, vascular irregularity, vascular dilatation, solitary red spots, diffuse red spots, and hemorrhoids in 26, 32, 30, 25, 10 and 25, respectively, of35 PH patients compared to 3, 7, 3, ll, 0 and 19, respectively, in controls. PHC was endoscopically diagnosed in 27 of 35 PHpatients according to our criteria. These patients with PHCwere more frequently associated with esophageal varices and portal hypertensive gastropathy, and had higher HVPG than PHpatients without PHC. Portal hypertension is an important factor in the etiology of PHC. (Internal Medicine 34: 153-157, 1995)

A study on portal hypertensive colopathy in patients with cirrhosis of liver

“…But there was a significant association between portal hypertension and colonic mucosal changes with a P value of 0.000, which proves that cirrhotic patients with increase in portal pressure develop PHC. Contrary to one prior study 12 it was observed in our study that colonic mucosal changes associated with upper GI endoscopy findings such as esophageal varices and PHTG with a statistically significant P value of 0.037. The positive association was due to portal hypertension which is the common denominator for mucosal changes of whole GI tract in cirrhosis of liver.…”

Clinicopathological Evaluation Of Portal Hypertensive Colopathy In Cirrhotic Patients

“…This association is explained by the result of increased hyperkinetic circulation observed in patients with worsening Child-Pugh class and advanced liver disease. In contrast to previous other studies, we noted an interesting association between alcohol intake and PHC [12][13][14][15]which to our knowledge has not been reported previously. This may be possibly due to relatively high number of patients with alcoholic cirrhosis in our cohort and selection bias.…”

Avoiding Pitfalls: What an Endoscopist Should Know in Liver Transplantation—Part 1

“…Whether this was attributable to the predominance of viral cirrhosis in this study is not clear [165]. Endoscopic treatment of esophageal varices has no bearing on the natural history of portal colopathy [166][167][168]. They are commonly seen in the recto sigmoid and the ascending colon.…”