Evaluation of the Small Intestine by Video Capsule Endoscopy in Patients Candidates for Liver Transplantation

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.author FYLYK, Sonia N. FMUSP-HC
TOBARU, Andre
MESTIERI, Luiz H. FMUSP-HC
FARIAS, Alberto Q. FMUSP-HC
CARRILHO, Flair J. FMUSP-HC
D'ALBUQUERQUE, Luiz Augusto C. FMUSP-HC
MOURA, Eduardo G. De FMUSP-HC
SAKAI, Paulo FMUSP-HC
dc.date.issued 2012
dc.identifier.citation GASTROINTESTINAL ENDOSCOPY, v.75, n.4, suppl.S, p.268-268, 2012
dc.identifier.issn 0016-5107
dc.identifier.uri http://observatorio.fm.usp.br/handle/OPI/2877
dc.description.abstract Introduction: Recent studies suggest that in cirrhotic patients the small intestine can be affected by the consequences of a system of portal hypertension (PTH). This segment of the gastrointestinal tract, however, is hardly accessible for study. The video capsule endoscopy (VCE) is considered the gold standard exam for the investigation of small bowel diseases, especially vascular diseases of the intestinal mucosa. Objective: Evaluation of the findings of PTH in the mucosa of the small bowel of cirrhotic patients, candidates for liver transplantation (LT). Patients and Methods: Prospective, single-center, controlled study. All patients signed informed consent and the study was approved by the ethics committee. 21 patients were submitted to VCE and esophagogastroduodenoscopy (14 patients with liver cirrhosis candidates to LT and 7 control cases, with normal liver function and no evidence of PTH). Inclusion criteria: - Patients with liver cirrhosis of viral and/or alcoholic etiology and with indication for LT (Child-Pugh score A, B or C and MELD < 20). Patients submitted or not to endoscopic treatment of esophagogastric varices or GAVE. - Patients over 18 years. - Patients who agree to participate in the study. Exclusion criteria: - Patients with history of abdominal surgery and intestinal transit abnormalities. - Intestinal sub-occlusion or suspected gastroparesis. - Patients with congestive heart disease. - Patients with potentially hemorrhagic lesions that can contribute to anemia (ulcers, polyps) and not related to PTH. Results: The mucosal lesions of the small intestine secondary to portal hypertension were more common in cirrhotic patients than in control patients: 13/14 (92.8%) vs. 1/7 (14.2%). The reticular pattern of the mucosa (hypertensive enteropathy) was the most important finding of the cases (10/14 -71.4%), followed by vascular ectasia-like and varices of the jejunum and ileum (7/14 - 50%). Conclusion: This group of patients has significant changes in the mucosa of the small intestine secondary to PTH and this segment of the gastrointestinal tract may represent a site of bleeding, often classified as obscure. The VCE is an important tool for the identification of these lesions, contributing to a more accurate etiologic diagnosis.
dc.language.iso eng
dc.publisher MOSBY-ELSEVIER
dc.relation.ispartof Gastrointestinal Endoscopy
dc.rights restrictedAccess
dc.title Evaluation of the Small Intestine by Video Capsule Endoscopy in Patients Candidates for Liver Transplantation
dc.type conferenceObject
dc.rights.holder Copyright MOSBY-ELSEVIER
dc.description.conferencedate MAY 19-22, 2012
dc.description.conferencelocal San Diego - CA, EUA
dc.description.conferencename Digestive Disease Week (DDW)
dc.description.group LIM/07
dc.description.group LIM/37
dc.description.group LIM/35
dc.type.category meeting abstract
dc.type.version publishedVersion
hcfmusp.author FYLYK, Sonia N.:HC:ICHC
hcfmusp.author MESTIERI, Luiz H.:HC:ICHC
hcfmusp.author FARIAS, Alberto Q.:FM:MGT
hcfmusp.author CARRILHO, Flair J.:FM:MGT
hcfmusp.author D'ALBUQUERQUE, Luiz Augusto C.:FM:MGT
hcfmusp.author MOURA, Eduardo G. De:HC:ICHC
hcfmusp.author SAKAI, Paulo:FM:MGT
hcfmusp.author.external · TOBARU, Andre:Univ Sao Paulo, Sch Med, Gastrointestinal Endoscopy Unit, Sao Paulo, Brazil
hcfmusp.origem.id WOS:000304328001278
hcfmusp.publisher.city NEW YORK
hcfmusp.publisher.country USA
dc.description.index MEDLINE
hcfmusp.citation.wos 0
hcfmusp.affiliation.country Brasil


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