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[Non-cirrhotic portal hypertension: rare cause of upper gastrointestinal bleeding].
Ned Tijdschr Geneeskd. 2010; 154:A1276.NT

Abstract

In three patients, two men aged 57 and 53 years, and a 43-year-old woman, idiopathic portal hypertension, also called non-cirrhotic portal hypertension (NCPH), was diagnosed. The first two patients presented with haematemesis. They were treated by endoscopic rubber band ligation of oesophageal varices. In the second patient, placement of a transjugular intrahepatic portosystemic shunt (TIPS) was necessary due to failure of the ligation treatment. The third patient was treated for HIV infection and had a gastroscopy because of nausea and vomiting, which revealed oesophageal varicosis. None of the patients had liver function impairment. Two of the patients had been treated with medication known to be associated with NCPH (azathioprine for Crohn's disease (second patient) and didanosine for HIV infection (third patient)). These medications were discontinued. The histological features of the patients were heterogeneous (nodular regenerative hyperplasia, periportal fibrosis and periportal dilated structures), but consistent with NCPH. Portal hypertension in the Western world is mostly associated with liver cirrhosis. When portal hypertension occurs in association with patent portal and hepatic veins, and in the absence of liver cirrhosis, NCPH must be considered. The prognosis of this disease is much better than that of cirrhosis.

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Authors+Show Affiliations

Schouten JN
Afd. Maag-, darm- en leverziekten, Erasmus Medisch Centrum Rotterdam, The Netherlands. j.schouten@erasmusmc.nl
Verheij J
No affiliation info available
Janssen HL
No affiliation info available

MeSH

AdultDiagnosis, DifferentialEsophageal and Gastric VaricesFemaleGastrointestinal HemorrhageHumansHypertension, PortalLiver CirrhosisMaleMiddle AgedPortasystemic Shunt, Transjugular IntrahepaticPrognosis

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

dut

PubMed ID

20456763

Citation

Schouten, Jeoffrey N L., et al. "[Non-cirrhotic Portal Hypertension: Rare Cause of Upper Gastrointestinal Bleeding]." Nederlands Tijdschrift Voor Geneeskunde, vol. 154, 2010, pp. A1276.
Schouten JN, Verheij J, Janssen HL. [Non-cirrhotic portal hypertension: rare cause of upper gastrointestinal bleeding]. Ned Tijdschr Geneeskd. 2010;154:A1276.
Schouten, J. N., Verheij, J., & Janssen, H. L. (2010). [Non-cirrhotic portal hypertension: rare cause of upper gastrointestinal bleeding]. Nederlands Tijdschrift Voor Geneeskunde, 154, A1276.
Schouten JN, Verheij J, Janssen HL. [Non-cirrhotic Portal Hypertension: Rare Cause of Upper Gastrointestinal Bleeding]. Ned Tijdschr Geneeskd. 2010;154:A1276. PubMed PMID: 20456763.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Non-cirrhotic portal hypertension: rare cause of upper gastrointestinal bleeding]. AU - Schouten,Jeoffrey N L, AU - Verheij,Joanne, AU - Janssen,Harry L A, PY - 2010/5/12/entrez PY - 2010/5/12/pubmed PY - 2010/6/9/medline SP - A1276 EP - A1276 JF - Nederlands tijdschrift voor geneeskunde JO - Ned Tijdschr Geneeskd VL - 154 N2 - In three patients, two men aged 57 and 53 years, and a 43-year-old woman, idiopathic portal hypertension, also called non-cirrhotic portal hypertension (NCPH), was diagnosed. The first two patients presented with haematemesis. They were treated by endoscopic rubber band ligation of oesophageal varices. In the second patient, placement of a transjugular intrahepatic portosystemic shunt (TIPS) was necessary due to failure of the ligation treatment. The third patient was treated for HIV infection and had a gastroscopy because of nausea and vomiting, which revealed oesophageal varicosis. None of the patients had liver function impairment. Two of the patients had been treated with medication known to be associated with NCPH (azathioprine for Crohn's disease (second patient) and didanosine for HIV infection (third patient)). These medications were discontinued. The histological features of the patients were heterogeneous (nodular regenerative hyperplasia, periportal fibrosis and periportal dilated structures), but consistent with NCPH. Portal hypertension in the Western world is mostly associated with liver cirrhosis. When portal hypertension occurs in association with patent portal and hepatic veins, and in the absence of liver cirrhosis, NCPH must be considered. The prognosis of this disease is much better than that of cirrhosis. SN - 1876-8784 UR - https://www.unboundmedicine.com/medline/citation/20456763/[Non_cirrhotic_portal_hypertension:_rare_cause_of_upper_gastrointestinal_bleeding]_ L2 - https://www.ntvg.nl/A1276 DB - PRIME DP - Unbound Medicine ER -