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Congestive gastropathy in cirrhotic patients: correlation between endoscopic and histological findings
1Department of Internal Medicine, Taipei Municipal Jen-Ai Hospital, Taiwan, Republic of China.
Insights
Congestive gastropathy is prevalent in liver cirrhosis patients, often detected endoscopically. Its presence correlates with liver disease severity but not with specific histological findings.
Area of Science:
- Gastroenterology
- Hepatology
- Internal Medicine
Background:
- Congestive gastropathy is a significant cause of gastrointestinal bleeding in patients with liver cirrhosis.
- Understanding its prevalence and diagnostic markers is crucial for patient management.
Purpose of the Study:
- To determine the prevalence of congestive gastropathy in cirrhotic patients.
- To investigate the relationship between endoscopic findings and histological features of congestive gastropathy.
- To assess the correlation between congestive gastropathy and the severity of liver disease.
Main Methods:
- A study involving 46 patients with liver cirrhosis and 225 age- and sex-matched controls without cirrhosis.
- Endoscopic examination to identify congestive gastropathy.
- Analysis of endoscopic biopsy specimens for histological correlation.
Main Results:
- Congestive gastropathy was significantly more common in cirrhotic patients (85%) compared to controls (5%).
- Endoscopic findings showed an 85% sensitivity, 95% specificity, and 76% positive predictive value.
- Endoscopic congestive gastropathy correlated with liver disease severity but not with etiology or esophageal varices.
- No significant correlation was found between endoscopic congestive gastropathy and histological features.
Conclusions:
- Congestive gastropathy is a frequent endoscopic finding in patients with liver cirrhosis.
- The severity of liver disease is closely linked to the presence of congestive gastropathy.
- Endoscopic diagnosis of congestive gastropathy does not reliably correlate with mucosal histology.
Abstract:
Congestive gastropathy is a common cause of gastrointestinal bleeding in cirrhotic patients. Forty-six patients with cirrhosis of the liver and 225 control subjects matched in age and sex without cirrhosis of the liver entered the study. We studied the prevalence of congestive gastropathy in cirrhotic patients, and the relationship between endoscopic and histological findings. Congestive gastropathy seen endoscopically was found to be more common in the cirrhotic group than in the control (85% vs. 5%, P < 0.05). The sensitivity, specificity and positive predictive value were 85%, 95% and 76%, respectively. The presence of endoscopic congestive gastropathy was correlated with the severity of liver disease (P < 0.05), but not to the etiology of cirrhosis and the size of esophageal varices with or without red color sign. Endoscopic congestive gastropathy showed no correlation with the histological features including gastritis, interstitial edema, vessel ectasia/congestion and hemosiderin in endoscopic biopsy specimens. In conclusion, congestive gastropathy is a common finding in cirrhotic patients. Its appearance is closely correlated with the severity of liver disease. There is no good correlation between endoscopic congestive gastropathy and mucosal histology.