Background and Study Aims: Portal hypertensive gastropathy (PHG) is a common finding in chronic liver disease,
but it has not been evaluated in hepatosplenic schistosomiasis, a significant cause
of noncirrhotic portal hypertension worldwide. Our study was aimed at comparing cirrhosis
with hepatosplenic schistosomiasis with regard to the endoscopic and histological
findings of PHG.
Patients and Methods: We included 43 patients with a history of upper digestive hemorrhage, 22 with cirrhosis
and 21 with schistosomiasis, without previous surgical or endoscopic treatment. Upper
digestive endoscopies with macrobiopsies of the gastric body were prospectively performed
in all cases.
Results: The endoscopic signs of PHG were more prevalent in cirrhosis than schistosomiasis
(81.8 % vs. 33.3 %; P < 0.05), and the mosaic pattern was the main finding. Histological abnormalities
were evenly distributed.
Conclusions: In agreement with other investigations, this study shows a lower prevalence of endoscopic
findings of portal hypertensive gastropathy in noncirrhotic diseases. This difference
cannot be explained by the underlying microscopic alterations, which were similar
in both groups, suggesting that other factors must play a role in its pathogenesis.
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D. Marques Chaves, M.D.
Endoscopy Service · Unit of São Paulo School of Medicine
Rua Montezuma 183 · 05436-080 São Paulo · Brazil
Fax: + 55-11-259-3065
eMail: dalton.chaves@fleury.com.br
