Colonic Disease in Cirrhotic Patients With Portal Hypertension: An Endoscopic and Clinical Evaluation

Fifty cirrhotic patients with portal hypertension but without colonic or systemic disease underwent lower gastrointestinal endoscopy in order to investigate the effects, if any, of portal hypertension on the colon. Fifty patients without liver or systemic disease, examined by colonoscopy because of...

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Bibliographic Details
Published in:	Journal of clinical gastroenterology Vol. 26; no. 3; pp. 222 - 227
Main Authors:	Bresci, Giampaolo, Gambardella, Luigi, Parisi, Giuseppe, Federici, Graziana, Bertini, Marco, Rindi, Goffredo, Metrangolo, Salvatore, Tumino, Emanuele, Bertoni, Michele, Cagno, M Cristina, Capria, Alfonso
Format:	Journal Article
Language:	English
Published:	United States Lippincott-Raven Publishers 01-04-1998
Subjects:	Adult Aged Angiodysplasia - diagnosis Angiodysplasia - pathology Biopsy Colitis - diagnosis Colitis - pathology Colon - blood supply Colon - pathology Colonic Diseases - diagnosis Colonic Diseases - pathology Colonoscopy Female Gastrointestinal Hemorrhage - etiology Gastrointestinal Hemorrhage - pathology Hemorrhoids - diagnosis Hemorrhoids - pathology Humans Hypertension, Portal - diagnosis Hypertension, Portal - pathology Liver Cirrhosis - diagnosis Liver Cirrhosis - pathology Male Middle Aged Varicose Veins - diagnosis Varicose Veins - pathology
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Summary:	Fifty cirrhotic patients with portal hypertension but without colonic or systemic disease underwent lower gastrointestinal endoscopy in order to investigate the effects, if any, of portal hypertension on the colon. Fifty patients without liver or systemic disease, examined by colonoscopy because of irritable bowel syndrome in the same period served as controls. Rectosigmoid varices were observed in 34% of the cirrhotic patients and 2% of the controls. Hemorrhoids were observed in 70% of the cirrhotic patients and 48% of the controls. Multiple vascular-appearing lesions were found in 16% of the cirrhotic patients and 6% of the controls. Nonspecific inflammatory changes were noted in 10% of the cirrhotic patients and 4% of the controls. Simultaneous presence, in the same patient, of rectosigmoid varices, hemorrhoids, multiple vascular-appearing lesions, and nonspecific inflammatory changes, was observed in only five (10%) of the cirrhotic patients. We found polyps in 12% of the cirrhotic patients and 14% of the controls, and a malignant tumor in 4% of the cirrhotic patients. The patients with normal colonoscopic findings were 8% of the cirrhotic patients and 36% of the controls.All patients and controls were followed up for 1 year; there was no gastrointestinal hemorrhage among controls, whereas 34% of the cirrhotic patients had an upper gastrointestinal hemorrhage (88% from esophageal varices, 12% from the stomach) and 4% had a lower gastrointestinal hemorrhage (one from rectosigmoid varices and one from nonspecific inflammatory lesions).Colonic lesions were significantly more frequent in the cirrhotic patients (92%) than in the control group (64%); however, such lesions did not seem specific to the disease and were not statistically correlated with the degree of esophageal varices by Child's grading, the etiology of cirrhosis, or the bleeding risk from the lower gastrointestinal tract.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0192-0790 1539-2031
DOI:	10.1097/00004836-199804000-00016