%0 Journal Article
%T Portal hypertensive enteropathy diagnosed by capsule endoscopy and demonstration of the ileal changes after transjugular intrahepatic portosystemic shunt placement: a case report
%A Alessandro Pezzoli
%A Nadia Fusetti
%A Loredana Simone
%A Angelo Zelante
%A Viviana Cifal¨¤
%A Alessandra Carella
%A Sergio Gullini
%J Journal of Medical Case Reports
%D 2011
%I BioMed Central
%R 10.1186/1752-1947-5-90
%X 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 ¦Â-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.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.Changes in the gastric mucosa are a well-known aspect of cirrhosis in patients with portal hypertension [1]. Some data suggest that similar abnormalities can also occur in the duodenum, jejunum, and distal ileum [2-4]. With the introduction of capsule endoscopy (CE) in clinical practice, these changes can be detected easily, and the so-called "portal hypertensive enteropathy" [5] seems more common [6-9]. We present a case of portal hypertensive enteropathy (PHE) in a cirrhosis patient shown by CE and the effect of transjugular intrahepatic portosystemic shunt (TIPS) placement on the ileal pictures.An 83-year-old Caucasian woman with cirrhosis was admitted several t
%U http://www.jmedicalcasereports.com/content/5/1/90