Spectrum of small-bowel mucosal abnormalities identified by capsule endoscopy in patients with portal hypertension of varied etiology

Chandrasekar, T. S.; Janakan, Gokul Bollu; Chandrasekar, Viveksandeep Thoguluva; Kalamegam, Raja Yogesh; Suriyanarayanan, S.; Sanjeevaraya, Prasad Menta

doi:10.1007/s12664-016-0721-5

Cited by 8 publications

(6 citation statements)

References 16 publications

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“…Owing to the poor accessibility of the small intestines, data on the endoscopic findings of the jejunum and ileum are limited [7-10]. The prevalence of PHE is high and varies from 40% to 96.8% [14-23], as shown in Table 4. This variation in the prevalence among studies may be attributable to the differences in their methodologies, particularly in the inclusion and exclusion criteria as well as in the definition of the various reported lesions.…”

Section: Discussionmentioning

confidence: 99%

“…This variation in the prevalence among studies may be attributable to the differences in their methodologies, particularly in the inclusion and exclusion criteria as well as in the definition of the various reported lesions. Moreover, the type of CE system used in the studies is also variable as most studies used first- or second-generation capsule systems [14-23].…”

Section: Discussionmentioning

confidence: 99%

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Mucosal Changes in the Small Intestines in Portal Hypertension: First Study Using the Pillcam SB3 Capsule Endoscopy System

et al. 2018

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Background/AimsTo evaluate patients with portal hypertension (PH) of varied etiologies for portal hypertensive enteropathy (PHE) using the PillCam SB3 capsule endoscopy (CE) system. MethodsConsecutive patients with PH presenting with unexplained anemia and/or occult gastrointestinal bleeding were evaluated using the PillCam SB3 CE system. Abnormal findings were categorized as vascular or non-vascular. The patients with ongoing bleeding caused by PHE were treated. The correlation of the CE scores of PHE with the clinical, laboratory, and endoscopic features was determined. ResultsOf the 43 patients included in the study, 41 (95.3%) showed PHE findings. These included varices (67.4%), red spots (60.5%), erythema (44.2%), villous edema (46.5%), telangiectasia (16.3%), and polyps (16.3%). The CE scores varied from 0 to 8 (mean±standard deviation, 4.09±1.8). Five patients (11.6%) showed evidence of ongoing or recent bleeding due to PHE. Three of these five patients underwent endotherapy, and one patient underwent radiological coil placement. ConclusionsThe PillCam SB3 CE system revealed a high prevalence of PHE in the patients with PH. Using this system, evidence of bleeding due to PHE was found in a small but definite proportion of the patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Mucosal Changes in the Small Intestines in Portal Hypertension: First Study Using the Pillcam SB3 Capsule Endoscopy System

et al. 2018

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“…It is being increasingly diagnosed, due to the advent of video capsule endoscopy and deep enteroscopy. In recent studies, the prevalence of PHE varies around 93-97%, with 8-12% of patients showing evidence of ongoing bleeding [62][63][64]. The findings of PHE are characterized as vascular (red spots, telangiectasia, or varices) and non-vascular or inflammatory (villous edema, erythema, or polyps) changes [64] (Figure 12a-f).…”

Section: Portal Hypertensive Enteropathy (Phe)mentioning

confidence: 99%

Endoscopy in Management of Portal Hypertension

Shah¹,

Goenka²,

Goenka³

2021

Portal Hypertension - Recent Advances

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Portal hypertension (PH) is a serious consequence of several disease states affecting prehepatic, intrahepatic, or posthepatic portal circulation. Backpressure caused by PH transmits through the collaterals to form varices at various sites. PH also leads to hyperdynamic congestion and altered gastrointestinal mucosal immune response, resulting in portal hypertensive gastropathy (PHG), portal hypertensive enteropathy (PHE), and portal colopathy (PC). These PH associated phenomena may lead to torrential life-threatening bleed or chronic blood loss leading to debilitating chronic anemia. Endoscopy plays a pivotal role in the management of these patients both for diagnostic and therapeutic purpose. The choice of therapeutic strategy depends on many factors: severity of the disease, patient’s clinical performance, and whether it is done as an emergency or as a prophylactic approach. In this chapter, we evaluate the endoscopic management of patients with the gastrointestinal complications of PH.

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“…Changes related to PH can be visualised on SBCE or DAE [4,5] and can occur in 15-96% of patients with PH [4][5][6][7][8][9][10][11]. PH changes can be manifested as mucosal inflammatory-like changes (oedema, erythema, granularity and friability) (Fig.…”

Section: Manifestations Of Portal Hypertension In the Small Bowelmentioning

confidence: 99%

Systemic manifestations – do not forget the small bowel

Zammit

Sidhu

2021

Current Opinion in Gastroenterology

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Purpose of review Systemic diseases can afflict the small bowel (SB) but be challenging to diagnose. In this review, we aim to provide a broad overview of these conditions and to summarise their management. Recent findings Small bowel capsule endoscopy (SBCE) is an important modality to investigate pathology in the SB. SB imaging can be complementary to SBCE for mural and extramural involvement and detection of multiorgan involvement or lymphadenopathy. Device assisted enteroscopy provides a therapeutic arm, to SBCE enabling histology and therapeutics to be carried out. Summary SB endoscopy is essential in the diagnosis, management and monitoring of these multi-system conditions. Collaboration across SB centres to combine experience will help to improve the management of some of these rarer SB conditions.

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Spectrum of small-bowel mucosal abnormalities identified by capsule endoscopy in patients with portal hypertension of varied etiology

Abstract: Small-bowel mucosal changes were seen in significantly higher number of patients with PHT with anemia.

Cited by 8 publications

References 16 publications

Mucosal Changes in the Small Intestines in Portal Hypertension: First Study Using the Pillcam SB3 Capsule Endoscopy System

Mucosal Changes in the Small Intestines in Portal Hypertension: First Study Using the Pillcam SB3 Capsule Endoscopy System

Endoscopy in Management of Portal Hypertension

Systemic manifestations – do not forget the small bowel

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