Clinical significance of small-bowel villous edema in patients with liver cirrhosis: A capsule endoscopy study

Autor: Ichiro Otani, Yuko Nagaoki, Hiroshi Aikata, Kazuaki Chayama, Shinji Tanaka, Akiyoshi Tsuboi, Sayoko Kunihara, Shiro Oka
Rok vydání: 2018
Předmět:
Zdroj: Journal of Gastroenterology and Hepatology. 33:825-830
ISSN: 0815-9319
Popis: Background and Aim The relationship between the presence of villous edema (VE) in portal hypertensive enteropathy (PHE) and clinical factors remains unclear. The aim of this study was to reveal the clinical factors related to VE in patients with liver cirrhosis (LC), and investigate the clinical significance of VE. Methods Between February 2009 and September 2016, 363 consecutive patients with liver cirrhosis underwent capsule endoscopy (CE) for diagnosing PHE at Hiroshima University Hospital. We evaluated the relationship between the presence of VE and patients’ clinical characteristics, findings of esophagogastroduodenoscopy and computed tomography, and survival time. Results VE was observed in 131 patients (36%), and severe lesions were found in 71 (20%). The presence of VE was significantly greater in patients with Child-Pugh classification B or C, esophageal varices (EVs), portal hypertensive gastropathy (PHG), ascites, portal vein thrombosis (PVT), and splenomegaly. In multivariate analysis, Child-Pugh class B or C, EVs, PVT, and splenomegaly were significant predictive factors for the presence of VE. Severe VE was significantly greater in patients with Child-Pugh class B or C, serum albumin level ≤3.2 mg/dL, PHG, and PVT. In multivariate analysis, PHG, Child-Pugh class B or C, PVT, and serum albumin level ≤3.2 mg/dL were significant predictive factors for severe VE. Conclusions Clinical factors related to portal hypertension were significantly correlated with VE. In particular PVT was correlated with the appearance and exacerbation of VE. Periodic CE in LC patients may lead to early detection of portal hypertension and PVT.
Databáze: OpenAIRE
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