Portal hypertensive colopathy is associated with portal hypertension severity in cirrhotic patients.
OBJECTIVE
To assess the prevalence of portal hypertension (PH) related colorectal lesions in liver transplant candidates, and to evaluate its association with the severity of PH.


METHODS
Between October 2004 and December 2005, colonoscopy was performed in 92 cirrhotic liver transplant candidates. We described the lesions resulting from colorectal PH and their association with the grade of PH in 77 patients who underwent measurement of hepatic venous pressure gradient (HVPG).


RESULTS
Mean age was 55 years and 80.7% of patients were men. The main etiology of cirrhosis was alcoholism (45.5%). Portal hypertensive colopathy (PHC) was found in 23.9%, colonic varices in 7.6% and polyps in 38% of patients (adenomatous type 65.2%). One asymptomatic patient had a well-differentiated adenocarcinoma. The manifestations of colorectal PH were not associated with the etiology of liver disease or with the Child-Pugh grade. Ninety percent of patients with colopathy presented with gastroesophageal varices (GEV), and 27.5% of patients with GEV presented with colopathy (P = 0.12). A relationship between higher values of HVPG and presence of colopathy was observed (19.9 +/- 6.2 mmHg vs 16.8 +/- 5.4 mmHg, P = 0.045), but not with the grade of colopathy (P = 0.13). Preneoplastic polyps and neoplasm (P = 0.02) and spontaneous bacterial peritonitis (P = 0.006) were more prevalent in patients with colopathy. We did not observe any association between previous beta-blocker therapy and the presence of colorectal portal hypertensive vasculopathy.


CONCLUSIONS
PHC is common in cirrhotic liver transplant candidates and is associated with higher portal pressure.
Diaz-Sanchez
Antonio
A
Liver Unit-CIBEREHD, Hospital General Universitario Gregorio Marañón, Madrid, Spain. antoniodisan@yahoo.es
Nuñez-Martinez
Oscar
O
Gonzalez-Asanza
Cecilia
C
Matilla
Ana
A
Merino
Beatriz
B
Rincon
Diego
D
Beceiro
Inmaculada
I
Catalina
Maria Vega
MV
Salcedo
Magdalena
M
Bañares
Rafael
R
Clemente
Gerardo
G
D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications; D003111:Colonic Polyps; D003113:Colonoscopy / Q000379:methods; D005260:Female; D006439:Hemodynamics; D006503:Hepatic Veins / Q000473:pathology; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications* / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000150:complications* / Q000503:physiopathology*; D016031:Liver Transplantation / Q000379:methods; D008297:Male; D008875:Middle Aged; D014690:Venous Pressure