Clinical and morphological characteristics of portal gastropathy in patients with liver cirrhosis


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Abstract

Aim. to study the clinical and morphological manifestations of portal gastropathy in patients with liver cirrhosis (LC).
Subjects and methods. One hundred and sixty-nine patients with Child-Pugh Classes B and C CL and 150 patients with gastritis and peptic ulcer disease without LC were examined. All the patients underwent fibrogastroscopy and morphological study of the gastric mucosa (GM). Morphological and serological studies detected Helicobacter pylori in all the patients.
Results. The endoscopic signs of portal gastropathy were found in 46.7-50.9% of the patients with LC; dilated capillaries and microbleedings in the GM were recorded in 73.9-83.7%. Ulcerative and erosive defects of the gastroduodenal area were identified in 31.9% of the patients with CL and these were accompanied by hemorrhages in 50% of cases. In patients with ulcers and erosions, the diameter of capillaries in different gastric portions was 23-56% larger than that in patients without these abnormalities. There was a significant direct correlation between the presence of H. pylori IgG and the morphological signs of portal gastropathy in the antrum.
Conclusion. An association was found between the signs of portal gastropathy and the presence of ulcerative and erosive defects in the gastroduodenal area in patients with LC.

References

  1. Левитан Б. Н., Дедов А. В. 50-Летний опыт клинического изучения циррозов печени. Рос. журн. гастроэнтерол., гепатол., колопроктол. 2002; 1: 76-79.
  2. Roberts S. E., Goldacre M. J., Yeates D. Trends in mortality after hospital admission for liver cirrhosis in an English population from 1968 to 1999. Gut 2005; 54 (6): 1615-1621.
  3. Kayasetin E., Efe D., Dogan G. Portal and splenic hemodynamic in cirrhosis patients: relationship between esophageal variceal bleeding and the severity of hepatic failure. J. Gastroenterol. 2004; 39 (2): 661-667.
  4. Kitano S., Dolgor B. Does portal hypertension to the pathogenesis of gastric ulcer associated with liver cirrhosis? J. Gastroenterol. 2000; 35 (2): 79-86.
  5. Aurox J., Lamarque D., Roudot-Thoraval F. Gastroduodenal ulcer and erosions are related to portal hypertensive gastropathy and recent alcohol intake in cirrhotic patients. Dig. Dis. Sci. 2003; 48 (6): 1118-1123.
  6. Carpinelli L., Primignani M., Preatoni P. Portal hypertensive gastropathy: reproducibility of a classification, prevalence of elementary lesions, sensitivity and specificity in the diagnosis of the cirrhosis of the liver. Ital. J. Gastroenterol. Hepatol. 1997; 29 (2): 533-540.
  7. Pugh R. N. H. Transsection of the esophagus for bleeding esophageal varices. Brt. J. Surg. 1973; 60 (2): 649-654.
  8. Knodel R. G., Ishak K. G., Black W. C. Formulation and application of numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis. Hepatology 1981; 1 (1): 431-435.
  9. EASL international consensus conference of Hepatitis B. Consensus statement. J. Hepatol. 2003; 38 (2): 533-540.
  10. Strader D. B., Wright Т., Thomas D. L., Seef L. B. Diagnosis, management and treatment of hepatitis С. Hepatology 2004; 39 (4): 1147-1171.
  11. Cacciola I., Pollicino Т., Squadrito G. Quantification of intrahepatic hepatitis В virus DNA in patients with chronic HBV infection. Hepatology 2000; 31 (2): 508-511.
  12. Farci P., Alter H. J., Wong D. A long-term study of hepatitis С virus replication in non-A, non-B hepatitis. N. Engl. J. Med. 1991; 325 (1): 98-104.
  13. Wiley Т. Е., McCarthy M., Breidi L. Impact of alcohol on the histological and clinical progression of hepatitis С infection. Hepatology 1998; 28 (3): 805-809.
  14. Огурцов П. П. Алкогольная болезнь печени и "алкогольный орнамент". Гепатол. форум 2005; 4: 2-7.
  15. Burak K. W., Lee S. S., Beck P. I. Portal hypertensive gastropathy and gastric antral vascular ectasia (GAVE) syndrome. Gut 2001; 49 (3): 866-872.
  16. Corley D. A., Stephan A. M., Wolf M. Early indicators of prognosis in upper gastrointestinal hemorrhage. Am. J. Gastroenterol. 1998; 93 (3): 336-340.
  17. Аруин Л. И., Григорьев П. Я., Исаков В. А., Яковенко З. П. Хронический гастрит. Амстердам; 1993.
  18. Dixon M. F., Genta R. M., Yardley J. H. Histological classification of gastritis and Helicobacter pylori infection: an agreement at last? The International Workshop on the Histopathology of Gastritis. Helicobacter 1997; 2 (1): 17-24.
  19. Самсонов В. А. Язвенная болезнь. Новые материалы к патоморфологии основных ее форм. Петрозаводск: Карелия; 1975.
  20. Автандилов Г. Г. Медицинская морфометрия: Руководство. М.: Медицина; 1990.
  21. Лапина Т. Л. Основные принципы диагностики Helicobacter Pylori. Рос. журн. гастроэнтерол., гепатол., колопроктол. 1999; 2: 41-45.
  22. Логинов А. С. Лечение эрозивно-язвенных поражений верхних отделов ЖКТ при декомпенсированном циррозе печени. Сов. мед. 1989; 11: 76-79.
  23. Gupta R., Saraswat V. A. Frequency and factors influencing portal hypertensive gastropathy and duodenopathy in cirrhotic portal hypertension. J. Gastroenterol. Hepatol. 1996; 32 (11): 728-733.
  24. Primignani M., Dell'Era A., Fazzini L. Portal hypertensive gastropathy in patients with cirrhosis of the liver. Recenti Progr. Med. 2001; 92 (12): 735-740.
  25. Tran A., Villeneue J. P. Treatment of chronic bleeding from gastric antral vascular ectasia (GAVE) with estrogen-progesterone in cirrhotic patients: an open pilot study. Am. J. Gastroenterol. 1999; 94: 2909-2911.
  26. Кислый Н. Д. Алкогольный цирроз печени как фактор дестабилизации основных функций организма: Автореф. дис. ... д-ра. мед. наук. М.; 2004.
  27. Misra V., Misra S. P., Dwivedi M. Thickened gastric mucosal capillary wall: a histological marker for portal hypertension. Pathology 1998; 30 (1): 10-13.
  28. Farinati F. Helicobacter pylori and the liver: any relationship? Ital. J. Gastroenterol. Hepatol. 1998; 30 (1): 124-128.
  29. Cadiot G. What role today for Helicobacter pylori in peptic ulcer? Gastroenterol. Clin. Biol. 2003; 27 (3): 409-414.
  30. Хомерики С. Г., Мельникова С. В., Обуховский Б. И. Клинико-морфологические проявления гастропатии у больных с портальной гипертензией. Гепатология 2005; 1: 8-15.
  31. Calvet X., Navarro M., Gil M. Epidemiology of peptic ulcer disease in cirrhotic patients: role of Helicobacter pylori infection. Am. J. Gastroenterol. 1998; 93 (12): 2501-2507.
  32. Pellicano R. Helicobacter pylori seroprevalence in hepatitis С virus positive patients with cirrhosis. J. Hepatol. 2000; 33 (4): 648-650.

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