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Portal hypertensive enteropathy.

Parit Mekaroonkamol1, Robert Cohen1, Saurabh Chawla1

  • 1Parit Mekaroonkamol, Robert Cohen, Saurabh Chawla, Grady Memorial Hospital, Division of Digestive Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, United States.

World Journal of Hepatology
|March 3, 2015
PubMed
Summary
This summary is machine-generated.

Portal hypertensive enteropathy (PHE) involves small intestine changes due to portal hypertension. Advances in endoscopy improve diagnosis and understanding of this condition, aiding clinical management.

Keywords:
Ectopic varicesEnteropathyGastrointestinal bleedingIntestinal vasculopathyPortal hypertension

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Area of Science:

  • Gastroenterology
  • Hepatology
  • Endoscopy

Background:

  • Portal hypertensive enteropathy (PHE) refers to small intestine mucosal abnormalities in portal hypertension.
  • Increased accessibility via capsule endoscopy and deep enteroscopy has enhanced understanding of PHE.
  • PHE presents with diverse endoscopic findings, necessitating classification and severity grading systems.

Purpose of the Study:

  • To review current evidence on portal hypertensive enteropathy.
  • To emphasize classification, diagnosis, clinical manifestations, and management of PHE.
  • To propose a management schematic for ectopic variceal bleeding.

Main Methods:

  • Review of existing literature on portal hypertensive enteropathy.
  • Analysis of endoscopic, histopathological, and cross-sectional imaging findings.
  • Discussion of multidisciplinary management approaches for PHE-related bleeding.

Main Results:

  • PHE encompasses a spectrum of vascular and non-vascular lesions in the small intestine.
  • Clinical manifestations range from asymptomatic findings to severe gastrointestinal hemorrhage.
  • Diagnosis relies on endoscopic findings, supported by histopathology and imaging.

Conclusions:

  • Portal hypertensive enteropathy is increasingly recognized, with varied presentations and potential for severe bleeding.
  • Multidisciplinary management, focusing on resuscitation, portal pressure reduction, and endoscopic therapy, is crucial.
  • A structured approach to managing ectopic variceal bleeds in PHE is proposed.