Abstract
Introduction: The aim of this study was to determine the frequency of digestive lesions unrelated to portal hypertension during cirrhosis and to look for a possible correlation between these lesions and the severity of chronic liver disease. Material and method: Over a period of 15 months (April 1, 2014 to June 30, 2015), all the records of cirrhotic patients who followed up on an outpatient or inpatient basis in the hepato-gastroenterology department of the Aristide Le Dantec Hospital were collected. The data collected were as follows: age, sex, Child-Pugh severity score, etiology of cirrhosis, indication for endoscopy and endoscopic lesions observed. Results: Data were analyzed from 82 patient records with a mean age of 43 years (range 16 and 79 years) and a sex ratio of 1.4 (54 males). Cirrhosis was classified as Child-Pugh B in 47% of cases and Child-Pugh C in 35% of cases. The etiology was viral B in 75 patients (91.5%), B-D co-infection in 2 cases, and alcoholic in 1 case. The indication for oeso-gastroduodenal endoscopy was a systematic search for signs of portal hypertension in 66 cases (80.4%), upper gastrointestinal haemorrhage in 11 cases (13.4%) and epigastralgia in 6.2% of cases. Endoscopic lesions unrelated to portal hypertension were observed in 61 patients (74.4%). Peptic ulcer was present in 26 patients (31.7%), and congestive gastrobulbitis was observed in 38 patients (46.3%) and erosive gastrobulbitis in 32 patients (39%). Of the 43 upper GI endoscopies with biopsies, Helicobacter pylori was found at histology in 17 cases (39.5%). Eighteen patients (21.9%) had esophageal candidiasis. In multivariate analysis, there was no association between no portal hypertension lesions and the severity of cirrhosis. Conclusion:Upper gastro intestinal lesions unrelated to hypertension were present in 3/4 of cirrhotic patients. Peptic ulcer disease and congestive and erosive gastrobulbitis were the most frequently observed lesions. There was no significant association between non-PTH-related lesions and the severity of cirrhosis.
Highlights
The aim of this study was to determine the frequency of digestive lesions unrelated to portal hypertension during cirrhosis and to look for a possible correlation between these lesions and the severity of chronic liver disease
Peptic ulcer was present in 26 patients (31.7%), and congestive gastrobulbitis was observed in 38 patients (46.3%) and erosive gastrobulbitis in 32 patients (39%)
It is clearly established in many studies that the prevalence of peptic ulcer disease is higher in cirrhotic patients than in the general population; the relationship between Helicobacter pylori (H. pylori) infection and peptic ulcer disease in cirrhosis remains controversial
Summary
The aim of this study was to determine the frequency of digestive lesions unrelated to portal hypertension during cirrhosis and to look for a possible correlation between these lesions and the severity of chronic liver disease. Upper gastrointestinal lesions unrelated to portal hypertension are defined by all abnormalities of the esophago-gastroduodenal mucosa other than varicose veins, portal hypertension gastropathy and antral vascular ectasia. Apart from studies on the association between peptic ulcer disease and cirrhosis, few data are available on upper digestive lesions unrelated to portal hypertension during cirrhosis. It is clearly established in many studies that the prevalence of peptic ulcer disease is higher in cirrhotic patients than in the general population; the relationship between Helicobacter pylori (H. pylori) infection and peptic ulcer disease in cirrhosis remains controversial
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