Thickened gastric mucosal capillary wall: a histological marker for portal hypertension

To evaluate whether the diameter or thickness of the wall of mucosal capillaries in the stomach could be a useful histological marker of portal hypertension, gastric mucosal biopsies were taken from the fundus and antrum of 73 patients with cirrhosis of the liver and 64 healthy volunteers. The mean +/- SD diameter of mucosal capillaries in the fundus of patients was not significantly different from that in the control group (59.4 +/- 16.8 microns vs 53.5 +/- 16.5 microns, respectively; P = NS). However, the mean +/- SD diameter of the antral mucosal capillaries was significantly greater in patients compared to controls (61.3 +/- 18.1 microns vs 47.6 +/- 12.7 microns, respectively; P < 0.001). The mean +/- SD thickness of the fundal and antral capillary wall in the patients group (6.8 +/- 2.4 microns and 7.2 +/- 2.4 microns, respectively) was significantly greater than that in the control group (3.5 +/- 1.5 microns and 3.3 +/- 1.5 microns, respectively) (P < 0.001 for each). The overall diagnostic accuracy of antral mucosal capillary diameter to diagnose portal hypertension was 50%, while that of thickened fundal and antral mucosal capillary wall was 84% and 85%, respectively. It is concluded that the gastric mucosal capillary walls are thicker in patients with portal hypertension and that this is a more reliable histological marker of portal hypertension than dilated gastric mucosal capillaries.