Histomorphometric Study of Portal Hypertensive Enteropathy

Abstract

Histopathologic features of duodenal and jejunal mucosal biopsy specimens obtained from 58 patients with portal hypertension and 30 healthy volunteers were studied. Dilated mucosal vessels with thickened walls were seen in duodenal and jejunal biopsy specimens from 39 (67%) and 41 (71%) of the patients, respectively, compared with corresponding biopsy specimens from 8 (27%) and 6 (2%) of the control subjects. The difference between the two groups was statistically significant. Other important histologic features in the patient group included edema of the lamina propria, fibromuscular proliferation, a decreased villous/crypt ratio, and thickened muscularis mucosae. The mean +/- SD thickness of capillary wall and diameter were significantly more in the patient group compared with those in the control subjects. We conclude that thick-walled dilated vessels along with edema of the lamina propria, fibromuscular proliferation, a decreased villous/crypt ratio, and thickened muscularis mucosae form a characteristic picture of portal hypertensive enteropathy. These changes seem to be a part of the changes seen in the gastrointestinal tract of patients with portal hypertension without any meaningful clinical implication except the increased chance of occult gastrointestinal blood loss.

Influence of the Escherichia coli Nissle 1917 strain on complications of the chronic experimental liver damage

“…Unfortunately, the morphological findings of damage were not in correlation with the level of the portal pressure or BT. Misra et al (1997) described the findings of enteropathy caused by portal hypertension. Their description is based on biopsy specimens obtained from the duodenum and jejunum of human patients.…”

Hypertensive portal colopathy in schistosomiasis mansoni: proposal for a classification

“…of the colonic mucosa are secondary to the vessel wall thickness present in this study with moderate to accentuated intensity in 51.6% of the cases. This can be explained by the chronic increase of the intraluminal pressure (Misra et al 1997). Endoscopic biopsies of the vascular lesions in the colonic mucosa were avoided due to the high risk of bleeding (Tam et al 1995).…”

Improvement of Schistosomal Portal Hypertensive Colopathy After Surgical Treatment

“…The histological sections were stained with Masson's trichrome (13) and used for histomorphometry in a semi-automatic microscope (Axiolab; Carl Zeiss, Oberkochen, Germany) equipped with an image-capture card and the Image-Lab software (Softium, São Paulo, SP, Brazil). Various measurement for blood vessels followed the criteria of Misra et al (15) .…”