Department of Gastroenterology and Hepatology, University Hospital Muenster, 48149 Muenster, Germany.
University Hospital Muenster, Gerhard-Domagk-Institute of Pathology, 48149 Muenster, Germany.
Can J Gastroenterol Hepatol. 2018 Aug 1;2018:2182784. doi: 10.1155/2018/2182784. eCollection 2018.
Portal hypertension is a serious complication of liver cirrhosis.
To identify relevant endoscopic findings in patients with advanced cirrhosis and consecutive portal hypertension.
This was a retrospective study of liver transplant candidates who underwent upper gastrointestinal endoscopy between April 2011 and November 2015.
A total of 1,045 upper endoscopies were analyzed. Portal hypertensive gastric and duodenal polyps were frequently observed and were associated with thrombocytopenia (p = 0.040; OR: 2.4, 95% CI 1.04-5.50), Child-Pugh score > 6 (p = 0.033; OR: 2.3, 95% CI 1.07-4.92), Model for End Stage Liver Disease score > 16 (p = 0.030; OR: 4.1, 95% CI 1.14-15.00), and previous rubber band ligation (p < 0.001; OR = 5.2, 95% CI 2.5-10.7). These polyps often recurred after polypectomy; however, no malignant transformation occurred during the observational time until October 2017. The most common endoscopic finding was esophageal varices, observed in more than 90% of patients.
Portal hypertensive polyposis is common in patients with advanced cirrhosis. Our data suggest that these polyps have benign characteristics.
门静脉高压症是肝硬化的严重并发症。
识别晚期肝硬化和连续门静脉高压症患者的相关内镜表现。
这是一项回顾性研究，纳入了 2011 年 4 月至 2015 年 11 月期间接受上消化道内镜检查的肝移植候选者。
共分析了 1045 例上消化道内镜检查。门静脉高压性胃和十二指肠息肉常被观察到，与血小板减少症相关（p = 0.040；OR：2.4，95%CI 1.04-5.50）、Child-Pugh 评分>6（p = 0.033；OR：2.3，95%CI 1.07-4.92）、终末期肝病模型评分>16（p = 0.030；OR：4.1，95%CI 1.14-15.00）和之前的橡皮圈结扎（p < 0.001；OR = 5.2，95%CI 2.5-10.7）。这些息肉在息肉切除后常复发；然而，在 2017 年 10 月之前的观察期间，没有发生恶性转化。最常见的内镜表现是食管静脉曲张，超过 90%的患者存在。
门静脉高压性息肉病在晚期肝硬化患者中很常见。我们的数据表明这些息肉具有良性特征。
