Introduction Portal hypertensive enteropathy (PHE) remains difficult to diagnose in patients with cirrhosis and portal hypertension. Limited test choices exist for the inspection of the small bowel in these patients. Small bowel capsule endoscopy (SBCE) would be ideal in this situation but it is rarely performed.^1–3

Methods This was a retrospective study using the SBCE data base of our unit. We searched through 1,477 patients that had SBCE between 2005 and 2013. Patients with cirrhosis who underwent SBCE were identified, data retrieved and abstracted. The Fischer’s exact or the chi-square tests were used to compare between groups. A two-tailed P value of <0.05 was considered statistically significant.

Results We identified 53 patients with cirrhosis who underwent SCBE. We used PillCam^®SB (Given^®Imaging Ltd, Israel) system on 36 patients and the MiroCam^® capsule (IntroMedic Co, Korea) on 17 patients. Thirty patients were referred for iron deficiency anaemia, 15 for obscure gastrointestinal bleeding, and 4 for other indications.

Four data sets were not available for review at the time of the study, leaving 49 patients to be reviewed. Mean age was 61.19 ± 14.54 years (M/F=27/22). Table 1 shows the aetiologies of liver disease in these patients. Six SBCE examinations were incomplete. Thirty three patients had evidence of portal hypertensive gastropathy (PHG) and 17 patients had evidence of oesophageal varices. In total, 29 patients had SCBE evidence of PHE (67%). 28/29 (96.5%) of patients with PHE had also evidence of PHG. 13/17 (76.4%) patients with oesophageal varices had also evidence of PHE.

Our mean follow up was 58.0 ± 13.7 months. Twenty patients died during the follow up period. There was no correlation between the presence of PHE and aetiology of liver disease (P = 0.4261) or subsequent death (P= 0.2145).

Conclusion The prevalence of PHE in our study was 67%. SBCE is a useful tool in evaluating PHE in cirrhotic patients irrespective of aetiology.

References

1. Rondonotti E, et al. Capsule endoscopy in portal hypertension. Clin Liver Dis 2010;14:209–20.

2. Krystallis C, et al. Update of endoscopy in liver disease: more than just treating varices. World J Gastroenterol 2012;18:401–11

3. Sidhu R, et al. Does small bowel capsule endoscopy alter management in patients with liver disease? Scand J Gastroenterol 2011;46:123–4

Disclosure of Interest None Declared.