Effects of transjugular intrahepatic portosystemic shunt on changes in the small bowel mucosa of cirrhotic patients with portal hypertension
Background The introduction of capsule endoscopy (CE) has facilitated the detection of mucosal changes in the small bowel, and such mucosal changes have been noted in cirrhotic patients with portal hypertension; these changes are described as portal hypertensive enteropathy. The aim of this study wa...
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| Veröffentlicht in: | Journal of gastroenterology 2013-05, Vol.48 (5), p.633-639 |
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| creator | Matsushita, Yoko Narahara, Yoshiyuki Fujimori, Shunji Kanazawa, Hidenori Itokawa, Norio Fukuda, Takeshi Takahashi, Yoko Kondo, Chisa Kidokoro, Hideko Atsukawa, Masanori Nakatsuka, Katsuhisa Sakamoto, Choitsu |
| description | Background
The introduction of capsule endoscopy (CE) has facilitated the detection of mucosal changes in the small bowel, and such mucosal changes have been noted in cirrhotic patients with portal hypertension; these changes are described as portal hypertensive enteropathy. The aim of this study was to assess the effects of transjugular intrahepatic portosystemic shunt (TIPS) on the small bowel mucosal changes detected by CE in cirrhotic patients with portal hypertension.
Methods
TIPS was performed in fifteen cirrhotic patients with portal hypertension. All patients underwent CE before and 2 weeks after TIPS. The small bowel mucosal changes were defined as edema, angiodysplasia-like lesions, red spots, and small bowel varices. Changes in the portosystemic pressure gradient (PSG) and CE findings were evaluated.
Results
Before TIPS, small bowel edema was detected in all 15 patients, angiodysplasia-like lesions in 7, and red spots in 14 patients. The PSG decreased significantly, from 21.2 ± 2.6 before TIPS to 8.9 ± 3.3 mmHg (
p
|
| doi_str_mv | 10.1007/s00535-012-0660-6 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1352281311</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A714585759</galeid><sourcerecordid>A714585759</sourcerecordid><originalsourceid>FETCH-LOGICAL-c492t-540f55bbfb2ebd59da4fdfce06ef7ac3512273b4bead6a483a97b7a100e5c71f3</originalsourceid><addsrcrecordid>eNp1ks-O1SAUxonRONfRB3BjSNy46QgUSrucTMbRZBI3uiaUHm57Q6ECzeS-gw8tnTvjv2hYEA6_83E450PoNSUXlBD5PhEialERyirSNKRqnqAd5SUiOsaeoh3pOK8olfwMvUjpQAitiWifozPGuqblkuzQ92trweSEg8U5ap8O6351OuLJl-MIi86TwUuIOaRjyjCXUxpXn3Hw2Iza7yEVFucRcJq1c7gPd-DwvJqQ9KZqphjHcK9StMCXt-6mPN5raofH4wIxg09T8C_RM6tdglcP-zn6-uH6y9XH6vbzzaery9vK8I7lSnBiheh72zPoB9ENmtvBGiANWKlNLShjsu55D3poNG9r3cle6tIyEEZSW5-jdyfdJYZvK6Ss5ikZcE57CGtStBaMtbSmtKBv_0IPYY2-VLdRsu54J9kvaq8dqMnbUJpnNlF1KSkXrZCiK9TFP6iyhq2twYOdSvyPBHpKMDGkFMGqJU6zjkdFidocoE4OUMUBanOAakrOm4eC136G4WfG48gLwE5AKldlfPG3H_1X9QdWyr4T</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1357394972</pqid></control><display><type>article</type><title>Effects of transjugular intrahepatic portosystemic shunt on changes in the small bowel mucosa of cirrhotic patients with portal hypertension</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Matsushita, Yoko ; Narahara, Yoshiyuki ; Fujimori, Shunji ; Kanazawa, Hidenori ; Itokawa, Norio ; Fukuda, Takeshi ; Takahashi, Yoko ; Kondo, Chisa ; Kidokoro, Hideko ; Atsukawa, Masanori ; Nakatsuka, Katsuhisa ; Sakamoto, Choitsu</creator><creatorcontrib>Matsushita, Yoko ; Narahara, Yoshiyuki ; Fujimori, Shunji ; Kanazawa, Hidenori ; Itokawa, Norio ; Fukuda, Takeshi ; Takahashi, Yoko ; Kondo, Chisa ; Kidokoro, Hideko ; Atsukawa, Masanori ; Nakatsuka, Katsuhisa ; Sakamoto, Choitsu</creatorcontrib><description>Background
The introduction of capsule endoscopy (CE) has facilitated the detection of mucosal changes in the small bowel, and such mucosal changes have been noted in cirrhotic patients with portal hypertension; these changes are described as portal hypertensive enteropathy. The aim of this study was to assess the effects of transjugular intrahepatic portosystemic shunt (TIPS) on the small bowel mucosal changes detected by CE in cirrhotic patients with portal hypertension.
Methods
TIPS was performed in fifteen cirrhotic patients with portal hypertension. All patients underwent CE before and 2 weeks after TIPS. The small bowel mucosal changes were defined as edema, angiodysplasia-like lesions, red spots, and small bowel varices. Changes in the portosystemic pressure gradient (PSG) and CE findings were evaluated.
Results
Before TIPS, small bowel edema was detected in all 15 patients, angiodysplasia-like lesions in 7, and red spots in 14 patients. The PSG decreased significantly, from 21.2 ± 2.6 before TIPS to 8.9 ± 3.3 mmHg (
p
< 0.001) after the procedure. After TIPS, the small bowel edema was attenuated in 8 of the 15 patients. In two patients with angiodysplasia-like lesions and 4 with red spots, these lesions were attenuated after TIPS. The average score for small bowel edema and the grade of red spots were reduced significantly after TIPS (2.3 ± 0.7–1.8 ± 0.6,
p
< 0.005 and 1.6 ± 0.9–1.3 ± 0.7,
p
< 0.05, respectively). Small bowel varices were seen in 4 patients before TIPS and all these varices disappeared after TIPS.
Conclusions
In cirrhotic patients with portal hypertension, small bowel edema, red spots, and small bowel varices were attenuated after TIPS. Portal hypertension may be an important factor in the development of small bowel mucosal changes.</description><identifier>ISSN: 0944-1174</identifier><identifier>EISSN: 1435-5922</identifier><identifier>DOI: 10.1007/s00535-012-0660-6</identifier><identifier>PMID: 22968470</identifier><language>eng</language><publisher>Japan: Springer Japan</publisher><subject>Abdominal Surgery ; Biliary Tract ; Capsule Endoscopy ; Colorectal Surgery ; Female ; Gastroenterology ; Hepatology ; Humans ; Hypertension, Portal - complications ; Intestinal Mucosa - pathology ; Intestine, Small - pathology ; Liver cirrhosis ; Liver Cirrhosis - complications ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Article—Liver ; Pancreas ; Portal hypertension ; Portasystemic Shunt, Transjugular Intrahepatic ; Surgical Oncology</subject><ispartof>Journal of gastroenterology, 2013-05, Vol.48 (5), p.633-639</ispartof><rights>Springer 2012</rights><rights>COPYRIGHT 2013 Springer</rights><rights>Springer Japan 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c492t-540f55bbfb2ebd59da4fdfce06ef7ac3512273b4bead6a483a97b7a100e5c71f3</citedby><cites>FETCH-LOGICAL-c492t-540f55bbfb2ebd59da4fdfce06ef7ac3512273b4bead6a483a97b7a100e5c71f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00535-012-0660-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00535-012-0660-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22968470$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Matsushita, Yoko</creatorcontrib><creatorcontrib>Narahara, Yoshiyuki</creatorcontrib><creatorcontrib>Fujimori, Shunji</creatorcontrib><creatorcontrib>Kanazawa, Hidenori</creatorcontrib><creatorcontrib>Itokawa, Norio</creatorcontrib><creatorcontrib>Fukuda, Takeshi</creatorcontrib><creatorcontrib>Takahashi, Yoko</creatorcontrib><creatorcontrib>Kondo, Chisa</creatorcontrib><creatorcontrib>Kidokoro, Hideko</creatorcontrib><creatorcontrib>Atsukawa, Masanori</creatorcontrib><creatorcontrib>Nakatsuka, Katsuhisa</creatorcontrib><creatorcontrib>Sakamoto, Choitsu</creatorcontrib><title>Effects of transjugular intrahepatic portosystemic shunt on changes in the small bowel mucosa of cirrhotic patients with portal hypertension</title><title>Journal of gastroenterology</title><addtitle>J Gastroenterol</addtitle><addtitle>J Gastroenterol</addtitle><description>Background
The introduction of capsule endoscopy (CE) has facilitated the detection of mucosal changes in the small bowel, and such mucosal changes have been noted in cirrhotic patients with portal hypertension; these changes are described as portal hypertensive enteropathy. The aim of this study was to assess the effects of transjugular intrahepatic portosystemic shunt (TIPS) on the small bowel mucosal changes detected by CE in cirrhotic patients with portal hypertension.
Methods
TIPS was performed in fifteen cirrhotic patients with portal hypertension. All patients underwent CE before and 2 weeks after TIPS. The small bowel mucosal changes were defined as edema, angiodysplasia-like lesions, red spots, and small bowel varices. Changes in the portosystemic pressure gradient (PSG) and CE findings were evaluated.
Results
Before TIPS, small bowel edema was detected in all 15 patients, angiodysplasia-like lesions in 7, and red spots in 14 patients. The PSG decreased significantly, from 21.2 ± 2.6 before TIPS to 8.9 ± 3.3 mmHg (
p
< 0.001) after the procedure. After TIPS, the small bowel edema was attenuated in 8 of the 15 patients. In two patients with angiodysplasia-like lesions and 4 with red spots, these lesions were attenuated after TIPS. The average score for small bowel edema and the grade of red spots were reduced significantly after TIPS (2.3 ± 0.7–1.8 ± 0.6,
p
< 0.005 and 1.6 ± 0.9–1.3 ± 0.7,
p
< 0.05, respectively). Small bowel varices were seen in 4 patients before TIPS and all these varices disappeared after TIPS.
Conclusions
In cirrhotic patients with portal hypertension, small bowel edema, red spots, and small bowel varices were attenuated after TIPS. Portal hypertension may be an important factor in the development of small bowel mucosal changes.</description><subject>Abdominal Surgery</subject><subject>Biliary Tract</subject><subject>Capsule Endoscopy</subject><subject>Colorectal Surgery</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Hypertension, Portal - complications</subject><subject>Intestinal Mucosa - pathology</subject><subject>Intestine, Small - pathology</subject><subject>Liver cirrhosis</subject><subject>Liver Cirrhosis - complications</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original Article—Liver</subject><subject>Pancreas</subject><subject>Portal hypertension</subject><subject>Portasystemic Shunt, Transjugular Intrahepatic</subject><subject>Surgical Oncology</subject><issn>0944-1174</issn><issn>1435-5922</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1ks-O1SAUxonRONfRB3BjSNy46QgUSrucTMbRZBI3uiaUHm57Q6ECzeS-gw8tnTvjv2hYEA6_83E450PoNSUXlBD5PhEialERyirSNKRqnqAd5SUiOsaeoh3pOK8olfwMvUjpQAitiWifozPGuqblkuzQ92trweSEg8U5ap8O6351OuLJl-MIi86TwUuIOaRjyjCXUxpXn3Hw2Iza7yEVFucRcJq1c7gPd-DwvJqQ9KZqphjHcK9StMCXt-6mPN5raofH4wIxg09T8C_RM6tdglcP-zn6-uH6y9XH6vbzzaery9vK8I7lSnBiheh72zPoB9ENmtvBGiANWKlNLShjsu55D3poNG9r3cle6tIyEEZSW5-jdyfdJYZvK6Ss5ikZcE57CGtStBaMtbSmtKBv_0IPYY2-VLdRsu54J9kvaq8dqMnbUJpnNlF1KSkXrZCiK9TFP6iyhq2twYOdSvyPBHpKMDGkFMGqJU6zjkdFidocoE4OUMUBanOAakrOm4eC136G4WfG48gLwE5AKldlfPG3H_1X9QdWyr4T</recordid><startdate>20130501</startdate><enddate>20130501</enddate><creator>Matsushita, Yoko</creator><creator>Narahara, Yoshiyuki</creator><creator>Fujimori, Shunji</creator><creator>Kanazawa, Hidenori</creator><creator>Itokawa, Norio</creator><creator>Fukuda, Takeshi</creator><creator>Takahashi, Yoko</creator><creator>Kondo, Chisa</creator><creator>Kidokoro, Hideko</creator><creator>Atsukawa, Masanori</creator><creator>Nakatsuka, Katsuhisa</creator><creator>Sakamoto, Choitsu</creator><general>Springer Japan</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20130501</creationdate><title>Effects of transjugular intrahepatic portosystemic shunt on changes in the small bowel mucosa of cirrhotic patients with portal hypertension</title><author>Matsushita, Yoko ; Narahara, Yoshiyuki ; Fujimori, Shunji ; Kanazawa, Hidenori ; Itokawa, Norio ; Fukuda, Takeshi ; Takahashi, Yoko ; Kondo, Chisa ; Kidokoro, Hideko ; Atsukawa, Masanori ; Nakatsuka, Katsuhisa ; Sakamoto, Choitsu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c492t-540f55bbfb2ebd59da4fdfce06ef7ac3512273b4bead6a483a97b7a100e5c71f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Abdominal Surgery</topic><topic>Biliary Tract</topic><topic>Capsule Endoscopy</topic><topic>Colorectal Surgery</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Hypertension, Portal - complications</topic><topic>Intestinal Mucosa - pathology</topic><topic>Intestine, Small - pathology</topic><topic>Liver cirrhosis</topic><topic>Liver Cirrhosis - complications</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original Article—Liver</topic><topic>Pancreas</topic><topic>Portal hypertension</topic><topic>Portasystemic Shunt, Transjugular Intrahepatic</topic><topic>Surgical Oncology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Matsushita, Yoko</creatorcontrib><creatorcontrib>Narahara, Yoshiyuki</creatorcontrib><creatorcontrib>Fujimori, Shunji</creatorcontrib><creatorcontrib>Kanazawa, Hidenori</creatorcontrib><creatorcontrib>Itokawa, Norio</creatorcontrib><creatorcontrib>Fukuda, Takeshi</creatorcontrib><creatorcontrib>Takahashi, Yoko</creatorcontrib><creatorcontrib>Kondo, Chisa</creatorcontrib><creatorcontrib>Kidokoro, Hideko</creatorcontrib><creatorcontrib>Atsukawa, Masanori</creatorcontrib><creatorcontrib>Nakatsuka, Katsuhisa</creatorcontrib><creatorcontrib>Sakamoto, Choitsu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of gastroenterology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Matsushita, Yoko</au><au>Narahara, Yoshiyuki</au><au>Fujimori, Shunji</au><au>Kanazawa, Hidenori</au><au>Itokawa, Norio</au><au>Fukuda, Takeshi</au><au>Takahashi, Yoko</au><au>Kondo, Chisa</au><au>Kidokoro, Hideko</au><au>Atsukawa, Masanori</au><au>Nakatsuka, Katsuhisa</au><au>Sakamoto, Choitsu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of transjugular intrahepatic portosystemic shunt on changes in the small bowel mucosa of cirrhotic patients with portal hypertension</atitle><jtitle>Journal of gastroenterology</jtitle><stitle>J Gastroenterol</stitle><addtitle>J Gastroenterol</addtitle><date>2013-05-01</date><risdate>2013</risdate><volume>48</volume><issue>5</issue><spage>633</spage><epage>639</epage><pages>633-639</pages><issn>0944-1174</issn><eissn>1435-5922</eissn><abstract>Background
The introduction of capsule endoscopy (CE) has facilitated the detection of mucosal changes in the small bowel, and such mucosal changes have been noted in cirrhotic patients with portal hypertension; these changes are described as portal hypertensive enteropathy. The aim of this study was to assess the effects of transjugular intrahepatic portosystemic shunt (TIPS) on the small bowel mucosal changes detected by CE in cirrhotic patients with portal hypertension.
Methods
TIPS was performed in fifteen cirrhotic patients with portal hypertension. All patients underwent CE before and 2 weeks after TIPS. The small bowel mucosal changes were defined as edema, angiodysplasia-like lesions, red spots, and small bowel varices. Changes in the portosystemic pressure gradient (PSG) and CE findings were evaluated.
Results
Before TIPS, small bowel edema was detected in all 15 patients, angiodysplasia-like lesions in 7, and red spots in 14 patients. The PSG decreased significantly, from 21.2 ± 2.6 before TIPS to 8.9 ± 3.3 mmHg (
p
< 0.001) after the procedure. After TIPS, the small bowel edema was attenuated in 8 of the 15 patients. In two patients with angiodysplasia-like lesions and 4 with red spots, these lesions were attenuated after TIPS. The average score for small bowel edema and the grade of red spots were reduced significantly after TIPS (2.3 ± 0.7–1.8 ± 0.6,
p
< 0.005 and 1.6 ± 0.9–1.3 ± 0.7,
p
< 0.05, respectively). Small bowel varices were seen in 4 patients before TIPS and all these varices disappeared after TIPS.
Conclusions
In cirrhotic patients with portal hypertension, small bowel edema, red spots, and small bowel varices were attenuated after TIPS. Portal hypertension may be an important factor in the development of small bowel mucosal changes.</abstract><cop>Japan</cop><pub>Springer Japan</pub><pmid>22968470</pmid><doi>10.1007/s00535-012-0660-6</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0944-1174 |
| ispartof | Journal of gastroenterology, 2013-05, Vol.48 (5), p.633-639 |
| issn | 0944-1174 1435-5922 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Abdominal Surgery Biliary Tract Capsule Endoscopy Colorectal Surgery Female Gastroenterology Hepatology Humans Hypertension, Portal - complications Intestinal Mucosa - pathology Intestine, Small - pathology Liver cirrhosis Liver Cirrhosis - complications Male Medicine Medicine & Public Health Middle Aged Original Article—Liver Pancreas Portal hypertension Portasystemic Shunt, Transjugular Intrahepatic Surgical Oncology |
| title | Effects of transjugular intrahepatic portosystemic shunt on changes in the small bowel mucosa of cirrhotic patients with portal hypertension |
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