Portal hypertensive gastropathy in noncirrhotic patients: the effect of lienorenal shunts

Soin, Arvinder Singh ; Acharya, Subrat Kumar ; Mathur, Meera ; Sahni, Peush ; Nundy, Samiran (1998) Portal hypertensive gastropathy in noncirrhotic patients: the effect of lienorenal shunts Journal of Clinical Gastroenterology, 26 (1). pp. 64-67. ISSN 0192-0790

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Official URL: http://journals.lww.com/jcge/Abstract/1998/01000/P...


We studied 25 consecutive patients with non-cirrhotic portal hypertension to determine whether portal hypertensive gastropathy occurred and whether it was related to hypoacidity, hypergastrinemia, or portal venous congestion. Preoperative tests included gastrointestinal endoscopy, gastric mucosal biopsies, gastric acid estimation, and serum gastrin measurements. All patients had a central splenorenal shunt performed during which a full-thickness gastric biopsy was performed. The tests were repeated 3 to 16 months postoperatively. Eight of the 25 patients showed endoscopic evidence of portal hypertensive gastropathy. The shunt procedure reversed the gastropathy in 6 of 7 patients followed up. Mucosal biopsies revealed vascular ectasia in 24 of 25 patients; in 8 of the most severely affected there was partial or complete regression after surgery. The basal and peak acid outputs in the patients were normal for our laboratory at 2.9 ± 0.25 meq/hour and 16.37 ± 0.96 meq/hour, respectively. They remained unchanged after surgery. Fasting serum gastrin levels were also normal both before and after surgery. Our findings indicate that venous congestion is the cause of portal hypertensive gastropathy in patients with noncirrhotic portal hypertension and that it can be reversed by a decompressive procedure.

Item Type:Article
Source:Copyright of this article belongs to Lippincott Williams and Wilkins.
Keywords:Portal Hypertensive Gastropathy; Extrahepatic Obstruction; Noncirrhotic Portal Fibrosis; Augmented Histamine Test; Endoscopic Biopsy; Vascular Ectasia
ID Code:150
Deposited On:17 Sep 2010 07:54
Last Modified:30 Dec 2010 06:53

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