Portal hypertensive jejunopathy: a case control study.
BACKGROUND
Small bowel mucosa is a recognized potential source of bleeding in portal hypertension. However, the frequency of its involvement is not known.


OBJECTIVE
To document the nature, severity and frequency of endoscopic and histologic changes in the jejunum in patients with portal hypertension.


METHODS
Forty consecutive patients with portal hypertension and 43 patients with non-ulcer dyspepsia (controls) underwent push enteroscopy and jejunal, duodenal and gastric biopsies. Biopsies were randomized and examined by a blinded pathologist for inflammation and vascular dilatation, which was quantified by morphometry.


RESULTS
Endoscopic jejunopathy was observed in 6 patients and none of the control subjects. All patients with jejunopathy had portal hypertensive gastropathy (PHG) and 5 had duodenopathy. Vascular dilatation was observed in 15 patients and 25 control subjects (p = ns). The degree of vascular dilatation was similar in both groups. Inflammatory changes were observed in 24 patients and 25 control subjects (p = 0.05).


CONCLUSIONS
Endoscopic jejunopathy was present in 15% of patients with portal hypertension. These changes were mild in 83% of them. All patients with jejunopathy also had PHG. Histologic changes were similar in patients and control subjects.
Desai
Nutan
N
Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and Municipal General Hospital, Mumbai. nchopda@yahoo.com
Desai
Devendra
D
Pethe
Vijayashree
V
Deodhar
K P
KP
Sawant
Prabha
P
Nanivadekar
Sucharita
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D016145:Endoscopy, Digestive System / Q000379:methods; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications*; D007413:Intestinal Mucosa / Q000098:blood supply*; D007579:Jejunal Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012720:Severity of Illness Index