Portal Hypertensive Polyposis in Advanced Liver Cirrhosis: The Unknown Entity?

Can J Gastroenterol Hepatol. 2018 Aug 1:2018:2182784. doi: 10.1155/2018/2182784. eCollection 2018.

Abstract

Background: Portal hypertension is a serious complication of liver cirrhosis.

Objective: To identify relevant endoscopic findings in patients with advanced cirrhosis and consecutive portal hypertension.

Methods: This was a retrospective study of liver transplant candidates who underwent upper gastrointestinal endoscopy between April 2011 and November 2015.

Results: A total of 1,045 upper endoscopies were analyzed. Portal hypertensive gastric and duodenal polyps were frequently observed and were associated with thrombocytopenia (p = 0.040; OR: 2.4, 95% CI 1.04-5.50), Child-Pugh score > 6 (p = 0.033; OR: 2.3, 95% CI 1.07-4.92), Model for End Stage Liver Disease score > 16 (p = 0.030; OR: 4.1, 95% CI 1.14-15.00), and previous rubber band ligation (p < 0.001; OR = 5.2, 95% CI 2.5-10.7). These polyps often recurred after polypectomy; however, no malignant transformation occurred during the observational time until October 2017. The most common endoscopic finding was esophageal varices, observed in more than 90% of patients.

Conclusion: Portal hypertensive polyposis is common in patients with advanced cirrhosis. Our data suggest that these polyps have benign characteristics.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Duodenal Diseases / complications*
  • Duodenal Diseases / diagnostic imaging
  • Duodenal Diseases / pathology
  • Duodenal Diseases / surgery
  • Endoscopy, Gastrointestinal
  • Esophageal and Gastric Varices / diagnostic imaging
  • Esophageal and Gastric Varices / etiology
  • Female
  • Humans
  • Hypertension, Portal / complications*
  • Intestinal Polyps / complications*
  • Intestinal Polyps / diagnostic imaging
  • Intestinal Polyps / pathology
  • Intestinal Polyps / surgery
  • Liver Cirrhosis / complications*
  • Male
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Stomach Diseases / complications*
  • Stomach Diseases / diagnostic imaging
  • Stomach Diseases / pathology
  • Stomach Diseases / surgery
  • Thrombocytopenia / complications
  • Young Adult