Gastrointestinal Endoscopy
November 2004 . Volume 60 . Number 5

Original Article
Ileal varices and portal hypertensive ileopathy in patients with
cirrhosis
and portal hypertension

Sri Prakash Misra, MD, DM, FRCP * [MEDLINE LOOKUP]
Manisha Dwivedi, MD, DM [MEDLINE LOOKUP]
Vatsala Misra, MD [MEDLINE LOOKUP]
Manisha Gupta, MB, BS [MEDLINE LOOKUP]

Abstract
Background The endoscopic appearance of portal hypertensive intestinal
vasculopathy is well described in the stomach, the jejunum, and the
colon,
but there is no description of changes that occur in the ileum.

Methods The terminal ileum was intubated at colonoscopy in 44 patients
with
cirrhosis and portal hypertension and 46 control patients. Changes in
the
terminal ileum were noted. In addition, anorectal varices and colopathy
were
carefully noted and recorded.

Results Ileal varices and/or portal hypertensive ileopathy were present
in
16 of 44 (36%) patients with cirrhosis and portal hypertension but not
in
any control patient (p < 0.01). Ileal varices were present in 8
patients
(18%) with cirrhosis/portal hypertension and none of the control
patients (p
< 0.05). Portal hypertensive ileopathy was noted in 11 patients (25%)
with
cirrhosis and portal hypertension and in none of the control patients
(p <
0.05). Ileal varices had no association with any other parameter
studied.
However, ileopathy was observed in 9 of the 23 patients with colopathy
and
in only two of the 21 patients without colopathy (p < 0.05).

Conclusions Ileal varices and mucosal changes of portal hypertensive
ileopathy occur in patients with cirrhosis and portal hypertension. In
the
population studied, ileopathy was significantly more common in patients
who
had portal hypertensive colopathy.

Publishing and Reprint Information

Current affiliations: Departments of Gastroenterology and Pathology,
Moti
Lal Nehru Medical College, Allahabad, India.
*Reprint requests: Sri Prakash Misra, MD, Department of
Gastroenterology,
Motilal Nehru Medical College, Allahabad 211 001, India.
Submitted April 2, 2004.
Accepted July 6, 2004.
Copyright © 2004 by American Society for Gastrointestinal Endoscopy





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