Portal Hypertensive Polyposis in Advanced Liver Cirrhosis: The Unknown Entity?

Abstract EN

Background.

Portal hypertension is a serious complication of liver cirrhosis.

Objective.

To identify relevant endoscopic findings in patients with advanced cirrhosis and consecutive portal hypertension.

Methods.

This was a retrospective study of liver transplant candidates who underwent upper gastrointestinal endoscopy between April 2011 and November 2015.

Results.

A total of 1,045 upper endoscopies were analyzed.

Portal hypertensive gastric and duodenal polyps were frequently observed and were associated with thrombocytopenia (p = 0.040; OR: 2.4, 95% CI 1.04–5.50), Child-Pugh score > 6 (p = 0.033; OR: 2.3, 95% CI 1.07–4.92), Model for End Stage Liver Disease score > 16 (p = 0.030; OR: 4.1, 95% CI 1.14–15.00), and previous rubber band ligation (p < 0.001; OR = 5.2, 95% CI 2.5–10.7).

These polyps often recurred after polypectomy; however, no malignant transformation occurred during the observational time until October 2017.

The most common endoscopic finding was esophageal varices, observed in more than 90% of patients.

Conclusion.

Portal hypertensive polyposis is common in patients with advanced cirrhosis.

Our data suggest that these polyps have benign characteristics.