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Portal hypertensive jejunopathy: a case control study.

Nutan Desai1, Devendra Desai, Vijayashree Pethe

  • 1Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and Municipal General Hospital, Mumbai. nchopda@yahoo.com

Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology
|July 15, 2004
PubMed
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Endoscopic jejunopathy, or changes in the small intestine, was found in 15% of patients with portal hypertension. These jejunal changes were typically mild and often accompanied by portal hypertensive gastropathy.

Area of Science:

  • Gastroenterology
  • Hepatology
  • Endoscopy

Background:

  • Small bowel mucosa is a potential bleeding source in portal hypertension.
  • The frequency of small bowel involvement in portal hypertension is not well-established.

Purpose of the Study:

  • To determine the nature, severity, and frequency of endoscopic and histologic changes in the jejunum of patients with portal hypertension.

Main Methods:

  • 40 patients with portal hypertension and 43 controls underwent push enteroscopy.
  • Jejunal, duodenal, and gastric biopsies were obtained and examined by a pathologist for inflammation and vascular dilatation.
  • Morphometry was used to quantify vascular changes.

Main Results:

  • Endoscopic jejunopathy was observed in 6 patients (15%) with portal hypertension, none in controls.

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  • All patients with jejunopathy also had portal hypertensive gastropathy (PHG).
  • Histologic inflammatory changes were similar between patients and controls, while vascular dilatation was also comparable.

    • Conclusions:

    • Endoscopic jejunopathy affects 15% of patients with portal hypertension and is usually mild.
    • Jejunal findings were associated with PHG.
    • Histologic changes in the jejunum did not significantly differ between patients with portal hypertension and controls.