Gensuke Akaike MD, Presenter: Nothing to Disclose

Takuya Ueda MD, Abstract Co-Author: Nothing to Disclose

Yoshiyuki Fujita, Abstract Co-Author: Nothing to Disclose

Kevin Urayama, Abstract Co-Author: Nothing to Disclose

Yasuyuki Kurihara MD, Abstract Co-Author: Nothing to Disclose

Masaki Matsusako MD, PhD, Abstract Co-Author: Nothing to Disclose

Yuka Morita MD, Abstract Co-Author: Nothing to Disclose

Takeshi Wada MD, Abstract Co-Author: Nothing to Disclose

Tomoya Nishiyama MD, Abstract Co-Author: Nothing to Disclose

Mariko Okura, Abstract Co-Author: Nothing to Disclose

Yuka Okajima MD, MPH, Abstract Co-Author: Nothing to Disclose

Kazuhiko Hosoya, Abstract Co-Author: Nothing to Disclose

Tsutomu Nihei, Abstract Co-Author: Nothing to Disclose

The purpose of this study was to evaluate the computed tomography (CT) findings of portal hypertensive colopathy (PHC) and its relation with various clinical features.

We retrospectively reviewed 163 consecutive patients with clinical diagnosis of liver cirrhosis who underwent contrast enhanced CT and blood examination within a 24 hour interval between January 2012 to January 2013 (median age: 69.0 years, range: 41-89, male103, female 60). Two board-certified radiologists with 22 and 6 years of experience in abdominal imaging reviewed the CT images. The presence and location of PHC, which was defined as submucosal thickening greater than 10 mm, was assessed. Associate CT findings including the followings were also evaluated; Gastroesophageal varices, gall bladder wall edema, splenomegaly, ascites, the diameter of main portal vein, and modified caudate-right lobe ratio (C/RL-m). The relationship between presence of PHC, clinical findings including Child-Pugh score and the associate CT findings was statistically assessed. Univariate statistics including chi-squared test, Student’s t-test, and Mann-Whitney U test were used as appropriate.

PHC was found in 39 out of 163 patients (29.3%). The location of PHC was the ascending colon in 34/39 patients (87.2%), the transverse colon in 18/39 patients (46.2 %), the descending colon in 11/39 patients (28.2%), the sigmoid colon in 9/39 patients (23.1%) and the rectum in 9/39 patients (23.1%). The presence of edema was significantly associated with higher Child-Pugh score (10.3%, 41.0% and 48.7% for Child-Pugh score A, B and C, respectively, p<0.001). The presence of PHC was significantly associated with esophageal varices (p<0.001), gastric varices (p=0.07), ascites (p<0.001) and gall bladder edema (p <0.001), but was not associated with splenomegaly, C/RL-m and diameter of the main portal vein.

The presence of PHC is significantly associated with cirrhosis severity and is more frequently observed in the ascending colon and the transverse colon. It is important to recognize PHC as it is sometimes mistaken for colitis.

Portal hypertensive colopathy (PHC) is a colonoscopic finding and the radiological feature is not fully understood. We found the characteristic distribution and relation with the clinical condition.

Akaike, G, Ueda, T, Fujita, Y, Urayama, K, Kurihara, Y, Matsusako, M, Morita, Y, Wada, T, Nishiyama, T, Okura, M, Okajima, Y, Hosoya, K, Nihei, T, Clinical and Radiological Features of Portal Hypertensive Colopathy: Common but Little-known Entity.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14008880.html