Portal hypertensive colopathy. A new entity.
The aim of this paper was, first, to show in a case control study that in alcoholic cirrhotic patients colonic vascular ectasias (VE) are a complication of portal hypertension and, second, to establish in a histomorphometric study that colonic vascular ectasias and rectal varices (RV) are only endoscopic features of a new entity: portal hypertensive colopathy, the pathologic basis of which is colonic mucosal capillary ectasia. In the case control study, for each case, three age- and sex-matched controls selected from consecutive patients were used. Sixteen alcoholic cirrhotic patients, 12 men, 4 women (mean age +/- SD: 62 +/- 10 years) had colonic vascular ectasias. The prevalence of esophageal varices (88% vs 44%, P less than 0.005), esophageal varices (greater than or equal to 5 mm) (44% vs 12.5%, P less than 0.01), previous history of bleeding from esophageal varices (44% vs 8%, P less than 0.005), and rectal varices (63% vs 6%, P less than 0.001) was significantly greater in cases with colonic vascular ectasias than in controls without colonic vascular ectasias. The relative risk of colonic vascular ectasias in alcoholic cirrhotic patients with esophageal varices versus cirrhotic patients without esophageal varices was 14.4 (95% confidence interval 2.8-75.3). In the histomorphometric study, cirrhotic patients with vascular ectasias and/or rectal varices had a significantly higher mean diameter of vessels (20.3 +/- 1.5 microns vs 18.7 +/- 1.6 microns, P less than 0.05) and a higher mean cross-sectional vascular area (2143 +/- 396 microns 2 vs 1676 +/- 345 microns 2, P less than 0.05) than cirrhotic patients without vascular ectasias and/or rectal varices.(ABSTRACT TRUNCATED AT 250 WORDS)
Naveau
S
S
Service d'Hépato-Gastroentérologie, Hôpital Antoine Béclère, Clamart, France.
Bedossa
P
P
Poynard
T
T
Mory
B
B
Chaput
J C
JC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016888:Angiodysplasia / Q000209:etiology* / Q000473:pathology; D001706:Biopsy; D002196:Capillaries / Q000473:pathology; D003106:Colon / Q000473:pathology; D003108:Colonic Diseases / Q000209:etiology* / Q000473:pathology; D003113:Colonoscopy; D004932:Esophageal and Gastric Varices / Q000150:complications; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications*; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies