Portal hypertensive enteropathy diagnosed by capsule endoscopy and demonstration of the ileal changes after transjugular intrahepatic portosystemic shunt placement: a case report
<p>Abstract</p> <p>Introduction</p> <p>Recent data suggest that mucosal abnormalities can occur even in the duodenum, jejunum, and distal ileum of cirrhosis patients. We present a case of portal hypertensive enteropathy in a cirrhosis patient shown by capsule endoscopy...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2011-03-01
|
| Series: | Journal of Medical Case Reports |
| Online Access: | http://www.jmedicalcasereports.com/content/5/1/90 |
| _version_ | 1818199248136568832 |
|---|---|
| author | Carella Alessandra Cifalà Viviana Zelante Angelo Simone Loredana Fusetti Nadia Pezzoli Alessandro Gullini Sergio |
| author_facet | Carella Alessandra Cifalà Viviana Zelante Angelo Simone Loredana Fusetti Nadia Pezzoli Alessandro Gullini Sergio |
| author_sort | Carella Alessandra |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Introduction</p> <p>Recent data suggest that mucosal abnormalities can occur even in the duodenum, jejunum, and distal ileum of cirrhosis patients. We present a case of portal hypertensive enteropathy in a cirrhosis patient shown by capsule endoscopy and the effect of transjugular intrahepatic portosystemic shunt on the ileal pictures.</p> <p>Case presentation</p> <p>An 83-year-old Caucasian woman was admitted to our hospital for anemia and a positive fecal occult blood test. An upper gastrointestinal endoscopy revealed small varices without bleeding signs and hypertensive gastropathy. Colonoscopy was negative. To rule out any other cause of bleeding, capsule endoscopy was performed; capsule endoscopy revealed severe hyperemia of the jejunum-ileal mucosa with active bleeding. Because of the persistence of anemia and the frequent blood transfusions, not responding to β-blocker drugs or octreotide infusion, a transjugular intrahepatic portosystemic shunt was performed. Anemia improved quickly after the transjugular intrahepatic portosystemic shunt, and no further blood transfusion was necessary in the follow-up. The patient developed portal encephalopathy two months later and was readmitted to our department. We repeated the capsule endoscopy that showed a significant improvement of the gastric and ileal mucosa without any signs of bleeding.</p> <p>Conclusion</p> <p>Hypertensive enteropathy is a rare condition, but it seems more common with the introduction of capsule endoscopy in clinical practice. This case shows that the jejunum can be a source of bleeding in cirrhosis patients, and this is the first demonstration of its resolution after transjugular intrahepatic portosystemic shunt placement.</p> |
| first_indexed | 2024-12-12T02:18:45Z |
| format | Article |
| id | doaj.art-0128238a24e04402aaea11875346a52d |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-12-12T02:18:45Z |
| publishDate | 2011-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-0128238a24e04402aaea11875346a52d2022-12-22T00:41:44ZengBMCJournal of Medical Case Reports1752-19472011-03-01519010.1186/1752-1947-5-90Portal hypertensive enteropathy diagnosed by capsule endoscopy and demonstration of the ileal changes after transjugular intrahepatic portosystemic shunt placement: a case reportCarella AlessandraCifalà VivianaZelante AngeloSimone LoredanaFusetti NadiaPezzoli AlessandroGullini Sergio<p>Abstract</p> <p>Introduction</p> <p>Recent data suggest that mucosal abnormalities can occur even in the duodenum, jejunum, and distal ileum of cirrhosis patients. We present a case of portal hypertensive enteropathy in a cirrhosis patient shown by capsule endoscopy and the effect of transjugular intrahepatic portosystemic shunt on the ileal pictures.</p> <p>Case presentation</p> <p>An 83-year-old Caucasian woman was admitted to our hospital for anemia and a positive fecal occult blood test. An upper gastrointestinal endoscopy revealed small varices without bleeding signs and hypertensive gastropathy. Colonoscopy was negative. To rule out any other cause of bleeding, capsule endoscopy was performed; capsule endoscopy revealed severe hyperemia of the jejunum-ileal mucosa with active bleeding. Because of the persistence of anemia and the frequent blood transfusions, not responding to β-blocker drugs or octreotide infusion, a transjugular intrahepatic portosystemic shunt was performed. Anemia improved quickly after the transjugular intrahepatic portosystemic shunt, and no further blood transfusion was necessary in the follow-up. The patient developed portal encephalopathy two months later and was readmitted to our department. We repeated the capsule endoscopy that showed a significant improvement of the gastric and ileal mucosa without any signs of bleeding.</p> <p>Conclusion</p> <p>Hypertensive enteropathy is a rare condition, but it seems more common with the introduction of capsule endoscopy in clinical practice. This case shows that the jejunum can be a source of bleeding in cirrhosis patients, and this is the first demonstration of its resolution after transjugular intrahepatic portosystemic shunt placement.</p>http://www.jmedicalcasereports.com/content/5/1/90 |
| spellingShingle | Carella Alessandra Cifalà Viviana Zelante Angelo Simone Loredana Fusetti Nadia Pezzoli Alessandro Gullini Sergio Portal hypertensive enteropathy diagnosed by capsule endoscopy and demonstration of the ileal changes after transjugular intrahepatic portosystemic shunt placement: a case report Journal of Medical Case Reports |
| title | Portal hypertensive enteropathy diagnosed by capsule endoscopy and demonstration of the ileal changes after transjugular intrahepatic portosystemic shunt placement: a case report |
| title_full | Portal hypertensive enteropathy diagnosed by capsule endoscopy and demonstration of the ileal changes after transjugular intrahepatic portosystemic shunt placement: a case report |
| title_fullStr | Portal hypertensive enteropathy diagnosed by capsule endoscopy and demonstration of the ileal changes after transjugular intrahepatic portosystemic shunt placement: a case report |
| title_full_unstemmed | Portal hypertensive enteropathy diagnosed by capsule endoscopy and demonstration of the ileal changes after transjugular intrahepatic portosystemic shunt placement: a case report |
| title_short | Portal hypertensive enteropathy diagnosed by capsule endoscopy and demonstration of the ileal changes after transjugular intrahepatic portosystemic shunt placement: a case report |
| title_sort | portal hypertensive enteropathy diagnosed by capsule endoscopy and demonstration of the ileal changes after transjugular intrahepatic portosystemic shunt placement a case report |
| url | http://www.jmedicalcasereports.com/content/5/1/90 |
| work_keys_str_mv | AT carellaalessandra portalhypertensiveenteropathydiagnosedbycapsuleendoscopyanddemonstrationoftheilealchangesaftertransjugularintrahepaticportosystemicshuntplacementacasereport AT cifalaviviana portalhypertensiveenteropathydiagnosedbycapsuleendoscopyanddemonstrationoftheilealchangesaftertransjugularintrahepaticportosystemicshuntplacementacasereport AT zelanteangelo portalhypertensiveenteropathydiagnosedbycapsuleendoscopyanddemonstrationoftheilealchangesaftertransjugularintrahepaticportosystemicshuntplacementacasereport AT simoneloredana portalhypertensiveenteropathydiagnosedbycapsuleendoscopyanddemonstrationoftheilealchangesaftertransjugularintrahepaticportosystemicshuntplacementacasereport AT fusettinadia portalhypertensiveenteropathydiagnosedbycapsuleendoscopyanddemonstrationoftheilealchangesaftertransjugularintrahepaticportosystemicshuntplacementacasereport AT pezzolialessandro portalhypertensiveenteropathydiagnosedbycapsuleendoscopyanddemonstrationoftheilealchangesaftertransjugularintrahepaticportosystemicshuntplacementacasereport AT gullinisergio portalhypertensiveenteropathydiagnosedbycapsuleendoscopyanddemonstrationoftheilealchangesaftertransjugularintrahepaticportosystemicshuntplacementacasereport |