Small bowel alterations in portal hypertension: a capsule endoscopic study.
OBJECTIVE
The endoscopic appearance in portal hypertension is well described in the stomach and the colon, but there is a limited number of data available on small bowel changes. The present retrospective, comparative study was aimed to analyse the diagnostic yield and describe the small bowel findings with capsule endoscopy in cirrhotic patients with gastrointestinal bleeding of unknown origin.


METHODS
Capsule endoscopy findings of 11 cirrhotic patients with portal hypertension and 22 non-cirrhotic patients with gastrointestinal bleeding who had undergone non-diagnostic upper endoscopy and colonoscopy, which were then compared.


RESULTS
In total, 9A and 2B cirrhotic patients were examined based on Child-Pugh score with a mean age of 66.2 (+/- 7.6) years. Lesions originated to portal hypertension were found in all cirrhotic patients, most frequently multiple angiodysplasias (63.6%), while in the control group multiple angiodysplasias were a seldom finding (18.2%). None of the radiological and endoscopic examinations of the small bowel before capsule endoscopy showed positive findings in cirrhotic patients.


CONCLUSIONS
Capsule endoscopy is an effective diagnostic method with high diagnostic yield in portal hypertension. Multiple angiodysplasias are the most probable findings as the source of small bowel bleeding in these patients.
Kovács
Márta
M
2nd Department of Internal Medicine, Vaszary Kolos Hospital, Esztergom, Hungary. drmarta.kovacs@t-online.hu
Pák
Péter
P
Pák
Gábor
G
Fehér
János
J
Rácz
István
I
D000368:Aged; D000704:Analysis of Variance; D053704:Capsule Endoscopy; D003113:Colonoscopy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis*; D006801:Humans; D006975:Hypertension, Portal / Q000473:pathology*; D007421:Intestine, Small / Q000473:pathology*; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies