Comparative study of portal hypertensive gastropathy in schistosomiasis and hepatic cirrhosis.
OBJECTIVE
Portal hypertensive gastropathy (PHG) is a common finding in chronic liver disease, but it has not been evaluated in hepatosplenic schistosomiasis, a significant cause of noncirrhotic portal hypertension worldwide. Our study was aimed at comparing cirrhosis with hepatosplenic schistosomiasis with regard to the endoscopic and histological findings of PHG.


METHODS
We included 43 patients with a history of upper digestive hemorrhage, 22 with cirrhosis and 21 with schistosomiasis, without previous surgical or endoscopic treatment. Upper digestive endoscopies with macrobiopsies of the gastric body were prospectively performed in all cases.


RESULTS
The endoscopic signs of PHG were more prevalent in cirrhosis than schistosomiasis (81.8 % vs. 33.3 %; P < 0.05), and the mosaic pattern was the main finding. Histological abnormalities were evenly distributed.


CONCLUSIONS
In agreement with other investigations, this study shows a lower prevalence of endoscopic findings of portal hypertensive gastropathy in noncirrhotic diseases. This difference cannot be explained by the underlying microscopic alterations, which were similar in both groups, suggesting that other factors must play a role in its pathogenesis.
Chaves
D Marques
DM
Endoscopy Service, University of São Paulo School of Medicine, São Paulo, Brazil. dalton.chaves@fleury.com.br
Sakai
P
P
Mucenic
M
M
Iriya
K
K
Iriya
Y
Y
Ishioka
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D004724:Endoscopy; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications*; D008103:Liver Cirrhosis / Q000150:complications*; D008109:Liver Diseases, Parasitic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012552:Schistosomiasis / Q000150:complications*; D013272:Stomach Diseases / Q000209:etiology*