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

Kara, David; Hüsing‐Kabar, Anna; Schmidt, Hartmut; Grünewald, Inga; Chandhok, Gursimran; Maschmeier, Miriam; Kabar, Iyad

doi:10.1155/2018/2182784

Cited by 17 publications

(26 citation statements)

References 25 publications

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“…The reason may be related to the fact that esophageal variceal band ligation leads to an increase in portosystemic shunt formations including the gastric wall. This hypothesis is also consistent with the histological finding of proliferative ectatic vessels in the gastric mucosa and strongly supports the hypothesis that elevated portal blood flow on the gastric mucosa distinctively stimulates proliferation [9].…”

Section: Discussionsupporting

confidence: 90%

“…As was the case in our study, most of the polyps here, too, were located in the gastric antrum and prepyloric areas. 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%

“…Portal hypertensive polyps are histologically similar to hyperplastic polyps [9,11], and they cannot be distinguished from the latter macroscopically either, but studies on the subject found that these portal hypertensive polyps had more small ulcerations on them when macroscopically evaluated [16,17]. The results of our study also revealed that such polyps mostly had small ulcerations on them.…”

Section: Discussionsupporting

confidence: 38%

“…Amarapurkar et al found in their study covering 3811 upper GI endoscopies that the prevalence of portal hypertensive polyps was 3.2%, similar to that of the normal population [4]. The prevalence of gastroduodenal polyps in the normal population varies between 0.5% and 6.35% [9,15].…”

Section: Discussionmentioning

confidence: 87%

“…Pathological analyses of portal hypertensive polyps in studies revealed foveolar hyperplasia, edema in lamina propria, and lamina propria ectatic capillaries. None had dysplasia and malignancy [5,9,16].…”

Section: Discussionmentioning

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: 90%

Section: Discussionsupporting

confidence: 50%