Ileal varices and portal hypertensive ileopathy in patients with cirrhosis and portal hypertension

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Gastrointestinal Endoscopy

November 2004 . Volume 60 . Number 5

Original Article

Ileal varices and portal hypertensive ileopathy in patients with cirrhosis

and portal hypertension

Sri Prakash Misra, MD, DM, FRCP * [MEDLINE LOOKUP]

Manisha Dwivedi, MD, DM [MEDLINE LOOKUP]

Vatsala Misra, MD [MEDLINE LOOKUP]

Manisha Gupta, MB, BS [MEDLINE LOOKUP]

Abstract

Background The endoscopic appearance of portal hypertensive intestinal

vasculopathy is well described in the stomach, the jejunum, and the colon,

but there is no description of changes that occur in the ileum.

Methods The terminal ileum was intubated at colonoscopy in 44 patients with

cirrhosis and portal hypertension and 46 control patients. Changes in the

terminal ileum were noted. In addition, anorectal varices and colopathy were

carefully noted and recorded.

Results Ileal varices and/or portal hypertensive ileopathy were present in

16 of 44 (36%) patients with cirrhosis and portal hypertension but not in

any control patient (p < 0.01). Ileal varices were present in 8 patients

(18%) with cirrhosis/portal hypertension and none of the control patients (p

< 0.05). Portal hypertensive ileopathy was noted in 11 patients (25%) with

cirrhosis and portal hypertension and in none of the control patients (p <

0.05). Ileal varices had no association with any other parameter studied.

However, ileopathy was observed in 9 of the 23 patients with colopathy and

in only two of the 21 patients without colopathy (p < 0.05).

Conclusions Ileal varices and mucosal changes of portal hypertensive

ileopathy occur in patients with cirrhosis and portal hypertension. In the

population studied, ileopathy was significantly more common in patients who

had portal hypertensive colopathy.

Publishing and Reprint Information

Current affiliations: Departments of Gastroenterology and Pathology, Moti

Lal Nehru Medical College, Allahabad, India.

*Reprint requests: Sri Prakash Misra, MD, Department of Gastroenterology,

Motilal Nehru Medical College, Allahabad 211 001, India.

Submitted April 2, 2004.

Accepted July 6, 2004.

Copyright © 2004 by American Society for Gastrointestinal Endoscopy