title: Small bowel capsule endoscopy and portal hypertensive enteropathy in cirrhotic patients: results from a tertiary referral centre.
abstract: OBJECTIVE
  Portal hypertensive enteropathy (PHE) remains difficult to diagnose in patients with cirrhosis and portal hypertension. Limited test choices exist for the inspection of the small bowel in these patients. Small bowel capsule endoscopy (SBCE) is ideal in this situation but rarely performed. We aimed to determine the prevalence of PHE using SBCE in a cirrhotic patient population and correlate its presence with clinical and CT imaging findings.
  
  
  METHODS
  We retrospectively analysed data from cirrhotic patients who underwent SBCE at our unit. Studies were evaluated for the presence of cirrhosis-related findings in the oesophagus, stomach and small-bowel. The relationships between PHE and patients' clinical characteristics were evaluated.
  
  
  RESULTS
  53 patients with cirrhosis underwent SCBE. We used PillCam®SB on 36 patients and MiroCam® capsule on 17. Thirty patients were referred for iron deficiency anaemia, 15 for obscure gastrointestinal bleeding, and 4 for other indications. Four data sets were not available for review, leaving 49 patients. Mean age was 61.19 ± 14.54 years (M/F = 27/22). Six SBCE examinations were incomplete. Thirty three patients had evidence of portal hypertensive gastropathy (PHG) and 17 had evidence of oesophageal varices. In total, 29 patients had SCBE evidence of PHE (57%). 28/29 (96.5%) patients with PHE had also evidence of PHG. 13/17 (76.4%) patients with oesophageal varices had also evidence of PHE.
  
  
  CONCLUSIONS
  The prevalence of PHE in our study was 57%. SBCE is a useful tool in evaluating PHE in cirrhotic patients irrespective of aetiology.
authors.affiliation: Centre of Liver and Digestive Disorders, Royal Infirmary of Edinburgh. Edinburgh, United Kingdom.
authors.forename: Konstantinos J
authors.initials: KJ
authors.lastname: Dabos
authors.affiliation: Centre of Liver and Digestive Disorders, Royal Infirmary of Edinburgh. Edinburgh, United Kingdom.
authors.forename: Diana E
authors.initials: DE
authors.lastname: Yung
authors.affiliation: Centre of Liver and Digestive Disorders, Royal Infirmary of Edinburgh. Edinburgh, United Kingdom.
authors.forename: Leonidas
authors.initials: L
authors.lastname: Bartzis
authors.affiliation: Centre of Liver and Digestive Disorders, Royal Infirmary of Edinburgh. Edinburgh, United Kingdom.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Hayes
authors.affiliation: Centre of Liver and Digestive Disorders, Royal Infirmary of Edinburgh. Edinburgh, United Kingdom.
authors.forename: John N
authors.initials: JN
authors.lastname: Plevris
authors.affiliation: Centre of Liver and Digestive Disorders, Royal Infirmary of Edinburgh. Edinburgh, United Kingdom.
authors.forename: Anastasios
authors.initials: A
authors.lastname: Koulaouzidis
mesh_terms: D000368:Aged; D053705:Capsule Endoscopes; D053704:Capsule Endoscopy / Q000295:instrumentation; D004867:Equipment Design; D004932:Esophageal and Gastric Varices / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D006975:Hypertension, Portal / Q000175:diagnosis / Q000453:epidemiology*; D007410:Intestinal Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology*; D007421:Intestine, Small / Q000473:pathology*; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D012606:Scotland / Q000453:epidemiology; D062606:Tertiary Care Centers; D014057:Tomography, X-Ray Computed