title: Spectrum of small-bowel mucosal abnormalities identified by capsule endoscopy in patients with portal hypertension of varied etiology.
abstract: BACKGROUND
  Bleeding from small intestinal ectopic varices and persistent anemia caused by portal hypertensive enteropathy (PHE) can be very challenging. Capsule endoscopy (CE) is one of the best noninvasive modalities in identifying such lesions.
  
  
  OBJECTIVE
  The aims of this study are to study the prevalence of small-bowel changes related to portal hypertension (PHT) and to correlate them with the observations related to the effects of portal hypertension in the esophagus, stomach, and colon.
  
  
  METHODS
  Thirty-two patients with various etiologies of PHT with either anemia or gastrointestinal bleed were included along with age- and sex-matched controls without PHT. All patients underwent blood tests, gastroscopy, colonoscopy, and CE. The small-bowel findings by CE were categorized as inflammatory-like and vascular lesions. The small-bowel changes were analyzed to find out any association with various demographic, clinical, and endoscopic variables.
  
  
  RESULTS
  Thirty-one out of 32 patients with PHT (96.8%) had PHE identified by CE. Of them, 31 (96.8%) had inflammatory-like appearance, 11 (34.4%) had vascular lesions, and 2 (6.2%) had small-bowel varices. Inflammatory-like appearance was noted in eight (25%) and angiodysplastic lesions in two (6.2%) controls. Findings compatible with PHE were detected in 96.8% of the patients and 25% of the controls (X2=34.72, p=0.000).The presence of PHE was not associated with any of the above-mentioned variables.
  
  
  CONCLUSIONS
  Small-bowel mucosal changes were seen in significantly higher number of patients with PHT with anemia.
authors.affiliation: Medindia Institute of Medical Specialities, 83, Valluvar Kottam High Road, Nungambakkam, Chennai, 600 034, India. tscmedindia@yahoo.com.
authors.forename: T S
authors.initials: TS
authors.lastname: Chandrasekar
authors.affiliation: Medindia Institute of Medical Specialities, 83, Valluvar Kottam High Road, Nungambakkam, Chennai, 600 034, India.
authors.forename: Gokul Bollu
authors.initials: GB
authors.lastname: Janakan
authors.affiliation: Medindia Institute of Medical Specialities, 83, Valluvar Kottam High Road, Nungambakkam, Chennai, 600 034, India.
authors.forename: Viveksandeep Thoguluva
authors.initials: VT
authors.lastname: Chandrasekar
authors.affiliation: Medindia Institute of Medical Specialities, 83, Valluvar Kottam High Road, Nungambakkam, Chennai, 600 034, India.
authors.forename: Raja Yogesh
authors.initials: RY
authors.lastname: Kalamegam
authors.affiliation: Medindia Institute of Medical Specialities, 83, Valluvar Kottam High Road, Nungambakkam, Chennai, 600 034, India.
authors.forename: Sathiamoorthy
authors.initials: S
authors.lastname: Suriyanarayanan
authors.affiliation: Medindia Institute of Medical Specialities, 83, Valluvar Kottam High Road, Nungambakkam, Chennai, 600 034, India.
authors.forename: Prasad Menta
authors.initials: PM
authors.lastname: Sanjeevaraya
mesh_terms: D000328:Adult; D000368:Aged; D000740:Anemia / Q000209:etiology; D053704:Capsule Endoscopy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000473:pathology; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications* / Q000473:pathology*; D007413:Intestinal Mucosa / Q000473:pathology*; D007421:Intestine, Small / Q000098:blood supply / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D014648:Varicose Veins / Q000209:etiology / Q000473:pathology
keywords: Anemia; Capsule endoscopy; Ectopic varices; Gastrointestinal bleeding; Portal hypertension; Portal hypertensive enteropathy