AI Article Synopsis
- The study aimed to assess the prevalence of portal hypertensive colopathy (PHC) in patients with cirrhosis and evaluate its diagnostic variability, relation to liver disease severity, and severe outcomes.
- A total of 102 participants (51 with cirrhosis and 51 healthy controls) were examined using advanced colonoscopy techniques, revealing a 71% prevalence of PHC among cirrhosis patients, with specific colonoscopic findings being significantly more common in this group compared to controls.
- Ultimately, while PHC was prevalent in patients with cirrhosis and had satisfactory diagnostic agreement, it showed no link to the severity of liver disease or significant negative health outcomes over a 12-month follow-up period.*
Article Abstract
Background: Management of portal hypertensive colopathy (PHC) has been challenged by controversial results in its prevalence and clinical relevance.
Objective: To describe the PHC prevalence and to evaluate the variability in diagnosis, the relation to severity of liver disease, and the incidence of severe outcomes.
Design: Cross-sectional study.
Setting: Endoscopic unit of a tertiary-care academic center in Rio de Janeiro, Brazil.
Patients: Patients with cirrhosis with portal hypertension and controls paired for age and sex.
Interventions: All patients were submitted to standard and image-enhanced colonoscopies, which were recorded in a coded video file and analyzed twice by a blinded endoscopist.
Main Outcome Measurements: The prevalence of PHC.
Results: A total of 51 patients with cirrhosis (55% male, mean age 59 years) and 51 healthy controls (43% male, mean age 61 years) were included. The top ranking colonoscopic findings were angiodysplasia-like lesions, nonspecific vascular pattern, red spots, and colorectal varices, all significantly more frequent in patients with cirrhosis compared with controls. PHC prevalence was 71% in patients with cirrhosis. For PHC, interobserver and intraobserver agreement (k values [standard error]) were 0.68 (0.09) and 0.63 (0.10), respectively. Intraobserver agreement for colonoscopic findings was satisfactory. PHC was not related to more severe liver disease or liver stiffness. Only 5 patients developed severe outcomes during follow-up.
Limitations: The exclusion of patients with cirrhosis without esophageal varices and the absence of an interobserver agreement analysis by double-blinded endoscopists.
Conclusion: PHC was highly prevalent in patients with cirrhosis, and its diagnostic agreement was satisfactory. PHC is not associated with relevant severe outcomes in a 12-month follow-up.
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| http://dx.doi.org/10.1016/j.gie.2015.01.036 | DOI Listing |
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