Transjugular intrahepatic portosystemic shunt for bleeding angiodysplasia-like lesions in portal-hypertensive colopathy

Balzer, Christoph; Lotterer, E.; Kleber, Gerhard

doi:10.1016/s0016-5085(98)70378-6

Cited by 23 publications

(8 citation statements)

References 29 publications

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“…In our study, very few patients had aortic stenosis and there were no significant differences between groups. Chronic liver disease, especially with associated portal hypertension, has also been linked to the presence of GI angioectasias and, as reported by some authors, they could be reversed after transjugular intrahepatic portosystemic shunt [34, 38, 39]. We found no significant differences between the two groups concerning the presence of chronic liver disease, which can be partly explained by the small number of patients included.…”

Section: Discussionsupporting

confidence: 49%

Is It Possible to Predict the Presence of Intestinal Angioectasias?

Gonçalves

Magalhães

Carvalho

et al. 2014

Diagnostic and Therapeutic Endoscopy

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Background and Aim. Angioectasias are the most common vascular anomalies found in the gastrointestinal tract. In small bowel (SB), they can cause obscure gastrointestinal bleeding (OGIB) and in this setting, small bowel capsule endoscopy (SBCE) is an important diagnostic tool. This study aimed to identify predictive factors for the presence of SB angioectasias, detected by SBCE. Methods. We retrospectively analyzed the results of 284 consecutive SBCE procedures between April 2006 and December 2012, whose indication was OGIB, of which 47 cases with SB angioectasias and 53 controls without vascular lesions were selected to enter the study. Demographic and clinical data were collected. Results. The mean age of subjects with angioectasias (70.9 ± 14.7) was significantly higher than in controls (53.1 ± 18.6; P < 0.001). The presence of SB angioectasias was significantly higher when the indication for the exam was overt OGIB versus occult OGIB (13/19 versus 34/81, P = 0.044). Hypertension and hypercholesterolemia were significantly associated with the presence of SB angioectasias (38/62 versus 9/38, P < 0.001 and 28/47 versus 19/53, P = 0.027, resp.). Other studied factors were not associated with small bowel angioectasias. Conclusions. In patients with OGIB, overt bleeding, older age, hypercholesterolemia, and hypertension are predictive of the presence of SB angioectasias detected by SBCE, which may be used to increase the diagnostic yield of the SBCE procedure and to reduce the proportion of nondiagnostic examinations.

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Section: Discussionsupporting

confidence: 49%

Is It Possible to Predict the Presence of Intestinal Angioectasias?

Gonçalves

Magalhães

Carvalho

et al. 2014

Diagnostic and Therapeutic Endoscopy

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show abstract

“…Interestingly, hypertensive colopathy is not correlated with the severity of liver disease or the presence of congestive gastropathy, but is more often associated with large esophageal varices. Treatment is not well defined, but correction of portal hypertension by transjugular intrahepatic portal-systemic shunt or liver transplant was reported to be effective in case of massive bleeding [5]. In this case, bleeding stopped, and we assume that the bleeding was related to a transient increase in portal hypertension according to the hepatic histology showing acute alcoholic hepatitis.…”

Section: Dear Sirmentioning

confidence: 78%

An Unusual Source of Gastrointestinal Bleeding

2000

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“…In one study of persistent bleeding from PHC in a patient with cirrhosis and portal hypertension that did not responded initially to propanol, bleeding was controlled after TIPS placement. 79 The portosystemic gradient was reduced after TIPS placement, and repeat colonoscopy at 9 days showed decrease in size and number of colonic lesions. The patient was followed up for 18 months without recurrence of GI bleeding.…”

Section: Portal Hypertensive Colopathymentioning

confidence: 90%

“…The patient was followed up for 18 months without recurrence of GI bleeding. 79 Another report demonstrated control of lower GI bleeding from numerous angiodysplastic spots in the right colon after a proximal splenorenal shunt with splenectomy. 75 …”

Section: Portal Hypertensive Colopathymentioning

confidence: 99%