Downloads
Abstract
Aim: This study was aimed to describe coloscopic characteristics in patients with cirrhosis and reveal the correlation between rectocolonic lesions and Child Pugh score as well as esophageal - endoscopy images.
Method: This study included 60 patients with cirrhosis hospitalized at the Department of Gastroenterology and Hepatology - Hue Central Hospital from April 2021 to October 2022. The study was conducted as a cross sectional research.
Results: Portal hypertensive colopathy was 76,7%. The lesions of the portal hypertensive colopathy were: redness 25%, solidarity ectasia 18,3%, diffuse ectasia 46,7%, blue vein 63,3% and mosac - like pattern 56,7%. These lesions were found at rectum 75%, sigmoid colon 61,7%, descending colon 51,7%, transverse colon 51,4%, ascending colon 35% and cecum 11,7%. Mosac - liked pattern, diffuse ectasia and blue vein were predominant at left - sided colon such as sigmoid colon, descending colon and rectum. Redness was detected overall colon. Solitary ectasia had no presence at rectum and cecum. There was a correlation between the portal hypertensive colopathy and grade of esophageal varices. The lesions in the descending colon were related to portal hypertensive gastropathy (p < 0,05), while those in the sigmoid colon had relation to the grade of esophageal varices (p < 0,05). The esophageal varices were the only risky factor of portal hypertensive colopathy (OR = 3,21; p = 0,019).
Conclusion: Portal hypertensive colopathy is common in cirrhosis. The lesions of portal hypertensive colopathy include redness, blue vein, solitary ectasia, diffuse ectasia and mosac - liked pattern. The grade of portal hypertensive colopathy increases with the severity of esophageal varices.
References
Asrani S K, Devarbhavi H, Eaton J. Burden of liver diseases
in the world. J Hepatol. 2019; 70(1): 151-171.
Cheemerla S, Balakrishnan M. Global Epidemiology of
Chronic Liver Disease. Clin Liver Dis (Hoboken). 2021;
(5): 365-370.
Song Huy Nguyen - Dinh, Albert Do, Trang Ngoc Doan
Pham. High burden of hepatocellular carcinoma and viral
hepatitis in Southern and Central Vietnam: Experience of a
large tertiary referral center 2010 to 2016. World J Hepatol.
; 10(1): 116-123.
GBD 2017 Cirrhosis Collaborators. The global, regional,
and national burden of cirrhosis by cause in 195 countries
and territories, 1990-2017: a systematic analysis for the
Global Burden of Disease Study 2017. Lancet Gastroenterol
Hepatol. 2020; 5(3): 245-266.
Rockey D C. An Update: Portal Hypertensive Gastropathy
and Colopathy. Clin Liver Dis. 2019; 23(4): 643-658.
Bini E J, Lascaride C E, Micale P L, Weinshel E H.
Mucosal abnormalities of the colon in patients with portal
hypertension: an endoscopic study. Gastrointest Endosc.
; 52(4): 511-6.
Diaz-Sanchez A, Nuñez - Martinez O, Gonzalez - Asanza
C. Portal hypertensive colopathy is associated with
portal hypertension severity in cirrhotic patients. World J
Gastroenterol. 2009; 15(38): 4781-7.
Franchis R D. Updating Consensus in Portal Hypertension:
Report of the Baveno III Consensus Workshop on
definitions, methodology and therapeutic strategies in
portal hypertension. Journal of Hepatology,. 2000,(33,):
-852,.
Naveau S, Bedossa P, Poynard T. Portal hypertensive
colopathy: A new entity. Dig Dis Sci. 1991; 36(12): 1774-81.
Gad Y, Zeid A. Portal hypertensive colopathy and
haematochezia in cirrhotic patients: an endoscopic study.
Arab J Gastroenterol. 2011; 12(4): 184-8.
Ito K, Shiraki K, Sakai T. Portal hypertensive colopathy in
patients with liver cirrhosis. World J Gastroenterol. 2005;
(20): 3127-30.
Malarvizhi M, Lagarsamy L, Shanmugam C. A study on
portal hypertensive colopathy in cirrhotic patients. Journal
of Dental and Medical Sciences. 2017; 16(9): 90-94.
Kumar R, Sahitya L, Prabhakar B. Colonoscopic Findings
in Cirrhotic Patients with Portal Hypertension. International
Journal Contemporary Medical Research. 2016; 3(6): 1-6.
Branco JC, Carvalho R, Alberto SF. Long-acting octreotide
is effective in the treatment of portal hypertensive colopathy.
Gastroenterol Hepatol. 2017; 40(8): 536-537.
Fantin A C, Zala G, Risti B. Bleeding anorectal varices:
successful treatment with transjugular intrahepatic
portosystemic shunting (TIPS). Gut. 1996; 38(6): 932-5.
Firoozi B, Gamagaris Z, Weinshel E H, Bini E J. Endoscopic
band ligation of bleeding rectal varices. Dig Dis Sci. 2002;
(7): 1502-5.
Philips C A, Sahney A. Oesophageal and gastric varices:
historical aspects, classification and grading: everything in
one place. Gastroenterol Rep (Oxf). 2016; 4(3): 186-95.
Sarin S K, Lahoti D, Saxen S. P, Murthy N, Makwana
U K. Prevalence, classification and natural history of
gastric varices: a long - term follow-up study in 568 portal
hypertension patients. Hepatology. 1992; 16(6): 1343-9.
Ganguly S, Sarin S K, Bhatia V. The prevalence and
spectrum of colonic lesions in patients with cirrhotic and
noncirrhotic portal hypertension. Hepatology. 1995; 21(5):
-31.
Trần Văn Huy, Xơ gan - Hội chứng ruột kích thích. Bài
giảng nội khoa. 2018: Trường Đại học Y Dược Huế.
Vaz J, Eriksson B, Strömberg U, Buchebner D. Incidence,
aetiology and related comorbidities of cirrhosis: a Swedish
population - based cohort study. BMC Gastroenterol. 2020;
(84): 1-8.
Phan Hồng Nhân, Nghiên cứu một số đặc điểm lâm sàng
và nội soi của xuất huyết tiêu hóa cao ở bệnh nhân xơ gan
mất bù, in Luận văn thạc sỹ y học. 2008, Trường Đại học Y
Dược Huế.
Tiwari PS, Sharma D, Paudel MS. Prevalence of Portal
Hypertensive Gastropathy in Chronic Liver Disease and
Correlation with the Severity of Liver disease. Cureus.
; 11(8): 1-11.
Korean Association for the Study of the Liver (KASL).
KASL clinical practice guidelines for liver cirrhosis:
Varices, hepatic encephalopathy, and related complications.
Clin Mol Hepatol. 2020; 26(2): 83-127.
Khalaf, Nazir M A, Galal G M. Pathogenesis of Portal
Hypertension and Esophageal Varices. Sohag Medical
Journal. 2018; 20(3): 343-348.
Nguyễn Văn Vỹ, Nghiên cứu đặc điểm lâm sàng, nội soi
và mô bệnh học bệnh lý dạ dày ở bệnh nhân xơ gan. 2011,
Luận án chuyên khoa cấp II, Trường Đại học Y Dược Huế.
Singh A, Verma N, Rathi R. New classification of gastric
varices: A twenty-year experience. Journal of Digestive
Endoscopy. 2021; 12(1): 24-30.
Sharma M, Rameshbabu CS. Collateral pathways in portal
hypertension. J Clin Exp Hepatol. 2012; 2(4): 338-52.
Trần Phạm Chí. Khảo sát đặc điểm hình ảnh nội soi, giải phẫu
bệnh của bệnh dạ dày tăng áp cửa ở bệnh nhân xơ gan. Tạp chí
Y Dược học - Trường Đại học Y Dược Huế. 2013; 16: 62-67.
Simbrunner B, Beer A, Wöran K. Portal hypertensive
gastropathy is associated with iron deficiency anemia. Wien
Klin Wochenschr. 2020; 132(1-2): 1-11.
Jeong I B, Lee T H, Lim S M. Endoscopic findings and
clinical significance of portal hypertensive colopathy.
Korean J Gastroenterol. 2011; 58(6): 332-7.
Salama ZA, Hassan A N, Darweesh S K. Colonic mucosal
changes in Egyptian patients with liver cirrhosis and portal
hypertension. The Egyptian Journal of Internal Medicine.
; 25: 196-201.
Misra S P, Dhingra V, Misra S P, Portal Hypertensive
Colopathy, in Colonoscopy. 2011, InTech. p. 171-176.
Nguyễn Quang Quyền, Gan - Ruột non - Ruột già. Bài
giảng Giải phẫu học. Vol. Tập 2. 2011: Nhà Xuất bản Y học
Guimarães R A, Perazzo H, Machado L. Prevalence,
variability, and outcomes in portal hypertensive colopathy:
a study in patients with cirrhosis and paired controls.
Gastrointest Endosc. 2015; 82(3): 469-76.
Yamakado S, Kanazawa H, Kobayashi M. Portal
hypertensive colopathy: endoscopic findings and the
relation to portal pressure. Intern Med. 1995; 34(3): 153-7.
Shalabya H, Meghawry E, Al-Azharyb A. Portal
hypertensive colopathy in Egyptian cirrhotic patients:
an endoscopic study. The Egyptian Journal of Internal
Medicine. 2018; 30(4): 249-254.
| Published | 20-08-2023 | |
| Fulltext |
|
|
| Language |
|
|
| Issue | No. 89 (2023) | |
| Section | Original article | |
| DOI | 10.38103/jcmhch.89.10 | |
| Keywords | Bệnh đại tràng tăng áp cửa, xơ gan, điểm đỏ, phù nề dạng khảm, giãn mạch đơn độc, giãn mạch lan tỏa, giãn tĩnh mạch, tăng áp cửa. Portal hypertensive colopathy, cirrhosis, redness, blue vein, solitary ectasia, diffuse ectasia, mosac - liked pattern, hypertension. |
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2023 Journal of Clinical Medicine Hue Central Hospital