Clinical Gastroenterology Vol.15 No.5(6)

Theme Portal Hypertension
Title Portal Hypertensive Colopathy
Publish Date 2000/05
Author Susumu Yamakado Division of Gastroenterology, Tokyo Metropolitan Tama Geriatric Hospital
Author Masafumi Kobayashi Third Department of Internal Medicine, Nippon Medical School
[ Summary ] Portal hypertensive colopathy (PHC) is a non-inflammatory disorder, that can only be diagnosed through endoscopic findings, including vascular ectasias (VE), vascular dilatation, vascular irregularities and colorectal varices. The frequencies of PHC lesions is not known. The pathogenesis is mainly related to portal hypertension, however several humoral factors are also associated. In chronic portal hypertension, colonic mucosal blood flow increased because of active congestion, introduced by splanchnic hyperemis. On the other hand, passive congestion theory is persuasive. The difference between the two theories is controversial. Active bleeding from PHC lesions is more rare than from PHG lesions. The best treatment for bleeding PHC lesions is thought to be coagulation by heat probes and argon plasma. A transjugular intrahepatic portosystemic shunt, which produces lowering of portal pressure, improves the condition of PHC lesions. This fact suggested PHC lesions were reversible. The criteria for PHC have not been set, therefore further investigation into PHC will be required.
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