Prevalence of portal hypertensive duodenopathy in cirrhosis: clinical and haemodynamic features.
OBJECTIVE
To estimate the prevalence of portal hypertensive duodenopathy (PHD) in patients with cirrhosis and portal hypertension, and to evaluate its relationship with clinical and haemodynamic parameters.


METHODS
Endoscopy reports and clinical history of 549 consecutive patients with cirrhosis and portal hypertension were evaluated retrospectively. A diagnosis of PHD was obtained in those patients with a congestive vascular pattern of the duodenum.


RESULTS
PHD was found in 46 patients (8.4%). Previous endoscopic band ligation and coexistence of severe gastropathy were significantly more frequent in PHD group. Systemic and hepatic haemodynamic evaluations were performed in 20 patients with PHD and 160 without PHD: the mean hepatic venous pressure gradient was higher in those cases with PHD (22.5 (5.4) vs. 19.8 (5.5) mmHg, P=0.045). Hypertensive colopathy was found in seven out of the 10 patients with PHD and a colonoscopic evaluation. In five of six patients PHD disappeared after liver transplant.


CONCLUSIONS
PHD is an uncommon finding of portal hypertension in cirrhotic patients. It is associated with previous endoscopic band ligation, to manifestations of portal hypertension in other sites of the gastrointestinal tract and to greater values of hepatic venous pressure gradient. The clinical relevance of this syndrome remains to be determined.
Menchén
Luis
L
Servicios de Aparato Digestivo, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Ripoll
Cristina
C
Marín-Jiménez
Ignacio
I
Colón
Arturo
A
Gómez-Camarero
Judith
J
González-Asanza
Cecilia
C
Menchén
Pedro
P
Cos
Enrique
E
Bañares
Rafael
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000453:epidemiology / Q000503:physiopathology; D004378:Duodenal Diseases / Q000453:epidemiology*; D016145:Endoscopy, Digestive System; D004932:Esophageal and Gastric Varices / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006503:Hepatic Veins / Q000503:physiopathology; D006801:Humans; D006975:Hypertension, Portal / Q000453:epidemiology* / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D014690:Venous Pressure / Q000502:physiology