title: Portal hypertensive colopathy is associated with portal hypertension severity in cirrhotic patients.
abstract: 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.
authors.affiliation: Liver Unit-CIBEREHD, Hospital General Universitario Gregorio Marañón, Madrid, Spain. antoniodisan@yahoo.es
authors.forename: Antonio
authors.initials: A
authors.lastname: Diaz-Sanchez
authors.forename: Oscar
authors.initials: O
authors.lastname: Nuñez-Martinez
authors.forename: Cecilia
authors.initials: C
authors.lastname: Gonzalez-Asanza
authors.forename: Ana
authors.initials: A
authors.lastname: Matilla
authors.forename: Beatriz
authors.initials: B
authors.lastname: Merino
authors.forename: Diego
authors.initials: D
authors.lastname: Rincon
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Beceiro
authors.forename: Maria Vega
authors.initials: MV
authors.lastname: Catalina
authors.forename: Magdalena
authors.initials: M
authors.lastname: Salcedo
authors.forename: Rafael
authors.initials: R
authors.lastname: Bañares
authors.forename: Gerardo
authors.initials: G
authors.lastname: Clemente
mesh_terms: 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