Endoscopic findings in upper gastrointestinal tract in patients with liver cirrhosis.

Czech version

Authors: P. Svoboda ¹; J. Ehrmann ²; P. Klvaňa ¹; E. Machytka ¹; M. Rydlo ¹; V. Hrabovský ¹
Authors‘ workplace: Interní klinika FN Ostrava, přednosta doc. MUDr. Arnošt Martínek, CSc. ¹; II. interní klinika Lékařské fakulty UP a FN Olomouc, přednosta doc. MUDr. Vlastimil Procházka, Ph. D. ²
Published in: Vnitř Lék 2007; 53(9): 968-971
Category: Original Contributions

Overview

151 patients suffering from the cirrhosis of the liver underwent a prospective endoscopic examination of the upper digestive tract. The most frequent diagnoses in the group with the cirrhosis of the liver included oesophagus varices (64.9 %), portal hypertension gastropathy (45,7 %) and the peptic ulcer of the gastroduodenum (25.8 %). A normal diagnosis in the endoscopy of the upper digestive tract was found only in 8.6 %. Other diagnoses comprised reflux oesophagitis (13.2 %), diaphragm hiatus hernia (12.6 %), duodenogastric reflux(8.6 %), gastric antrum erosion (4.6 %), aphthic gastropathy (3.3 %),rhagades of the cardium(2 %), gastric polyp (1.3 %), mycotic oesophagitis, gastric carcinoma, oesophagus carcinoma and oesophagus achalasy (0.7 % each). Further on the study discusses possible causes of the high incidence of peptic ulcers in the patients with the cirrhosis of the liver. All findings are correlated with literary data.

Key words:
liver cirrhosis - endoscopic diagnosis - portal hypertension - peptic ulcer -Helicobacter pylori

Sources

1. Mařatka Z. Illustrated terminology, definitions and diagnostic criteria in digestive endoscopy. Normed Verlag 1992.

2. Lata J, Dítě P, Hůlek P et al. Portální hypertenze při jaterní cirhóze a její důsledky. 1. ed. Plzeň: GAAN CZ 2000.

3. Mařatka Z. Gastroenterologie. 1. ed. Praha: Karolinum 1999.

4. Siringo S, Burroughs AK, Bolondi K et al. Peptic ulcer and its course in cirrhosis: an endoscopic and clinical prospective study. J Hepatol 1995; 22: 633-641.

5. Weiler H, Weiler Ch, Gerok W. Gastric mucosal prostaglandin E2 levels in cirrhosis and portal hypertension. J Hepatol 1990; 11: 58-64.

6. Rabinovitz M, Yoo YK, Schade RR et al. Prevalence of endoscopic findings in 510 consecutive individuals with cirrhosis evaluated prospectively. Dig Dis Sci 1990; 35: 705-710.

7. Tsai ChJ. Helicobacter pylori infection and peptic ulcer disease in cirrhosis. Dig Dis Sci 1998; 43: 1219-1225.

8. Auroux J, Lamarque D, Roudot-Thoraval F et al. Gastroduodenal ulcer and erosions are related to portal hypertensive gastropathy and recent alcohol intake in cirrhotic patients. Dig Dis Sci 2003; 48: 1118-1123.

9. Zaman A, Hapke R, Flora K et al. Prevalence of upper and lower gastrointestinal tract findings in liver transplant candidates undergoing screening endoscopic evaluation. Am J Gastroenterol 1999; 94: 895-899.

10. Chen JJ, Changchien ChS, Tai DI et al. Role of Helicobacter pylori in cirrhotic patients with peptic ulcer, a serological study. Dig Dis Sci 1994; 39: 1565-1568.

11. Wu ChS, Lin ChY, Liaw YF. Helicobacter pylori in cirrhotic patients with peptic ulcer disease: a prospective, case controlled study. Gastrointestinal Endosc 1995; 42: 424-427.

12. Payen JL, Cales P, Pienkowski P et al. Weakness of mucosal barrier in portal hypertensive gastropathy of alcoholic cirrhosis. Effect of propranolol and enprostil. J Hepatol 1995; 23: 689-696.

13. Kitano S, Dolgor B. Does portal hypertension contribute to the pathogenesis of gastric ulcer associated with liver cirrhosis? J Gastroenterol 2000; 35: 79-86.

14. Arakawa T, Satoh H, Fukuda T et al. Endogenous prostaglandin E2 in gastric mucosa of patients with alcoholic cirrhosis and portal hypertension. Gastroenterology 1987; 93: 135-140.

15. Taranto D, Suozzo R, Romano M et al. Gastric endoscopic features in patients with liver cirrhosis: correlation with esophageal varices, intravariceal pressure, and liver dysfunction. Digestion 1994; 55: 115-120.

16. Gostout ChJ, Viggiano TR, Balm RK. Acute gastrointestinal bleeding from portal hypertensive gastropathy: prevalence and clinical features. Am J Gastroenterol 1993; 88: 2030-2033.

17. Sacchetti C, Capello M, Rebecchi P et al. Frequency of upper gastrointestinal leasions in patients with liver cirrhosis. Dig Dis Sci 1988; 33: 1218-1222.

18. Cheung RC, Cooper S, Keeffe EB. Endoscopic gastrointestinal manifestations of liver disease. Gastrointest Endosc Clin N Am 2001; 11: 12-44.