Diaz-Sanchez A, Nuñez-Martinez O, Gonzalez-Asanza C, Matilla A, Merino B, Rincon D, Beceiro I, Catalina MV, Salcedo M, Bañares R, Clemente G. Portal hypertensive colopathy is associated with portal hypertension severity in cirrhotic patients. World J Gastroenterol 2009; 15(38): 4781-4787 [PMID: 19824111 DOI: 10.3748/wjg.15.4781]
Corresponding Author of This Article
Antonio Diaz-Sanchez, MD, Gastroenterology Unit, Hospital Infanta Leonor, Gran Vía del Este 80, Madrid 28031, Spain. antoniodisan@yahoo.es
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Brief Articles
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World J Gastroenterol. Oct 14, 2009; 15(38): 4781-4787 Published online Oct 14, 2009. doi: 10.3748/wjg.15.4781
Portal hypertensive colopathy is associated with portal hypertension severity in cirrhotic patients
Antonio Diaz-Sanchez, Oscar Nuñez-Martinez, Cecilia Gonzalez-Asanza, Ana Matilla, Beatriz Merino, Diego Rincon, Inmaculada Beceiro, Maria Vega Catalina, Magdalena Salcedo, Rafael Bañares, Gerardo Clemente
Antonio Diaz-Sanchez, Oscar Nuñez-Martinez, Cecilia Gonzalez-Asanza, Ana Matilla, Beatriz Merino, Diego Rincon, Maria Vega Catalina, Magdalena Salcedo, Rafael Bañares, Gerardo Clemente, Liver Unit-CIBEREHD. Hospital General Universitario Gregorio Marañón, Madrid 28007, Spain
Antonio Diaz-Sanchez, Gastroenterology Unit, Hospital Infanta Leonor, Gran Vía del Este 80, Madrid 28031, Spain
Oscar Nuñez-Martinez, Gastroenterology Unit, Hospital Infanta Sofia, Madrid 28702, Spain
Inmaculada Beceiro, Department of Gastroenterology, Hospital Universitario Príncipe de Asturias, Madrid 28820, Spain
Author contributions: Diaz-Sanchez A and Nuñez-Martinez O designed the study, performed the statistical analysis and wrote the manuscript; Matilla A and Merino B collected the data from patients and performed the statistical analysis; Gonzalez-Asanza C performed the gastrointestinal endoscopy; Rincon D and Bañares R performed the splanchnic hemodynamic study; Catalina MV, Beceiro I and Salcedo M collected the data from patients and performed clinical support and follow-up; Clemente G coordinated the study and provided financial support for this work.
Correspondence to: Antonio Diaz-Sanchez, MD, Gastroenterology Unit, Hospital Infanta Leonor, Gran Vía del Este 80, Madrid 28031, Spain. antoniodisan@yahoo.es
Telephone: +34-91-1918285 Fax: +34-91-1919090
Received: July 7, 2009 Revised: August 8, 2009 Accepted: August 15, 2009 Published online: October 14, 2009
Abstract
AIM: To assess the prevalence of portal hypertension (PH) related colorectal lesions in liver transplant candidates, and to evaluate its association with the severity of PH.
METHODS: Between October 2004 and December 2005, colonoscopy was performed in 92 cirrhotic liver transplant candidates. We described the lesions resulting from colorectal PH and their association with the grade of PH in 77 patients who underwent measurement of hepatic venous pressure gradient (HVPG).
RESULTS: Mean age was 55 years and 80.7% of patients were men. The main etiology of cirrhosis was alcoholism (45.5%). Portal hypertensive colopathy (PHC) was found in 23.9%, colonic varices in 7.6% and polyps in 38% of patients (adenomatous type 65.2%). One asymptomatic patient had a well-differentiated adenocarcinoma. The manifestations of colorectal PH were not associated with the etiology of liver disease or with the Child-Pugh grade. Ninety percent of patients with colopathy presented with gastroesophageal varices (GEV), and 27.5% of patients with GEV presented with colopathy (P = 0.12). A relationship between higher values of HVPG and presence of colopathy was observed (19.9 ± 6.2 mmHg vs 16.8 ± 5.4 mmHg, P = 0.045), but not with the grade of colopathy (P = 0.13). Preneoplastic polyps and neoplasm (P = 0.02) and spontaneous bacterial peritonitis (P = 0.006) were more prevalent in patients with colopathy. We did not observe any association between previous β-blocker therapy and the presence of colorectal portal hypertensive vasculopathy.
CONCLUSION: PHC is common in cirrhotic liver transplant candidates and is associated with higher portal pressure.
