scholarly journals A Study of Portal Hypertensive Polyps

2017 ◽  
Vol 4 (1) ◽  
pp. 88
Author(s):  
Aravind C. ◽  
Arul Murugan S. ◽  
Sai Ravi Kiran B.

Background: Portal hypertension induces mucosal changes like portal hypertensive gastropathy, duodenopathy and colonic mucosal abnormalities. These polyps are commonly found in the stomach than other parts of bowel. Portal hypertensive polyp usually occur in cirrhotic portal hypertension and are also in extra hepatic portal vein occlusion.  Diagnostic criteria for portal hypertensive polyp is not yet clearly described. Hence it becomes essential to evaluate the prevalence of polyps in portal hypertensive patients. The aim was to estimate the prevalence of portal hypertensive polyps in patients with portal hypertension due to any etiology.Methods: This is a prospective observational study of patients with portal hypertensive polyps. All patients in age group of 18 to 80 years who had portal hypertension diagnosed by clinical, laboratory and imaging criteria who went upper gastro intestinal endoscopy from the period of May 2012 to April 2013 were included in the study. Diagnosis of portal hypertensive polyps was confirmed histologically. Patients with proton pump inhibitor use, gastric varices,          h. pylori gastritis, history of inherited polyposis syndromes, patients who refused consent were excluded.Results: A total of 3,621upper GI endoscopies were done of which 428 patients had portal hypertension. Polyps were noted in 9 patients (2.1%). Out of 428 patients 366 had chronic liver disease and 62 had extrahepatic portal hypertension and out of them 1 was excluded due to Rapid urease test positivity. Histopathological examination showed four had extensive vascular proliferation and glandular hyperplasia (portal hypertensive polyp) two had hyperplastic polyp and other two had neuroendocrine tumour. Endoscopic appearances of polyps varied considerably, with sizes ranging from 5mm to 15 mm. Polyps were sessile or pedunculated, singular or multiple, found in the antrum, body of the stomach .There is no specific endoscopic features to identify portal hypertensive polyps.Conclusions: Portal hypertensive polyps are rare. There is no specific endoscopic features. Biopsy is necessary for diagnosis. Longterm studies are needed to characterise their significance.

2018 ◽  
Vol 5 (4) ◽  
pp. 1315
Author(s):  
Mrutyunjay I. Uppin ◽  
Kapildev K. Hannurkar

Background: Prevalence of Helicobacter pylori (H. pylori) emerges throughout the world and instigates peptic ulcer disease (PUD). The study was conducted with the aim to determine the prevalence of H. pylori in patients with PUD undergoing upper gastrointestinal endoscopy.Methods: This prospective study was conducted on 150 cases of PUD from August 2009 to February 2011. Endoscopy was done in all cases. Biopsy was done and sent for histopathological examination and rapid urease test for confirmation of presence of H. pylori.Results: Out of 150 patients with mean age of 45.76 years, 109 patients were diagnosed to have been infected with Helicobacter pylori (72.66%). Out of 89 patients with gastric ulcer, 61 patients were infected with Helicobacter pylori (68.53%). Forty two out of 51 patients (82.35%) with duodenal ulcers and 06 of 10 patients (60%) with carcinoma of stomach were positive for H. pylori. The remaining patients were found to be negative for the H. pylori infection.Conclusions: The findings of the study conclude that H. pylori was consistently associated with PUD.


2017 ◽  
Vol 4 (12) ◽  
pp. 4071
Author(s):  
Virendra S. Athavale ◽  
Vinit Singh ◽  
Shivmurti N. Khandalkar ◽  
Dakshayani S. Nirhale ◽  
Aditya Lad ◽  
...  

Background: Aims and objectives of the study was to study the incidence of H. pylori infection in our Hospital. To find out the sensitivity and specificity of rapid urease test (RUT) and histopathological examination for the detection of H. pylori on gastric biopsy. To study the effect of anti H. pylori drugs by performing follow-up endoscopy in terms of positive or negative Rapid Urease Test and Histopathological Examination report.Methods: The study was conducted at Dr. D. Y. Patil Medical College and Hospital, DPU University, for a period of 2 years (from July 2012-September 2014) and is a prospective and comparative randomized type of study using 100 patients. The study was approved by the Institute’s Ethics Committee.Results: Data analysis showed that: In our study 84 patients (84%) were detected positive by RUT method. In our study 83 patients (83 %) were detected positive by HPE method. There was an association between RUT and HPE finding in study group with the sensitivity being 96.38 % and specificity being 74.47 %, PPV was 95.24% and NPV was 81.25%. At the time of follow up after taking anti H pylori treatment, 79 patients were RUT negative and 8 were RUT positive who were defaulters (not taken complete dose) and again started on treatment with the accuracy of the drug being 98.85 %. At the time of follow up after taking anti H pylori treatment 78 patients were HPE negative and 9 were HPE positive who were defaulters (not taken complete dose) and again started on treatment. There was an association between RUT and HPE finding at follow up with the sensitivity being 88.89 % and specificity being 100%, PPV was 100% and NPV was 98.73%.Conclusions: Our study reveals that RUT is accurate for the diagnosis of H. pylori infection and its use will serve as a good alternative to histology in management of patients with dyspepsia in resource poor environments, except in patients who need histology for reasons other than H. pylori diagnosis.


2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Rania M. Kishk ◽  
Nashaat M. Soliman ◽  
Maha M. Anani ◽  
Nader Nemr ◽  
Ayman Salem ◽  
...  

Helicobacter pylori (H. pylori) plays a crucial role in the pathogenesis of gastritis, peptic ulcer, and gastric cancer. The presence of pathogenicity islands (PAI) genes contributes to the pathogenesis of many gastrointestinal disorders. Cytotoxin-associated gene A (cagA) and vacuolating cytotoxin gene (vacA) are the most known virulence genes in H. pylori. So, our aim was to study H. pylori virulence genes’ role in gastric disorders pathogenesis. Our study included 150 adult patients who suffered dyspeptic symptoms and were referred to the GIT endoscopy unit. Gastric biopsies were attained for rapid urease test (RUT) and histopathological examination, and multiplex PCR technique for detection of virulence genes was performed. It was found that 100 specimens were (RUT) positive, of which sixty samples (60%) were PCR positive for H. pylori ureC gene. The vacA and cagA genes were identified in 61.6% and 53% of H. pylori strains, respectively. Only 5 cases were vacA-positive and cagA-negative. The most virulent vacA s1 allele existed in 56.6% of cases. Out of the 60 H. pylori strains, 66% had at least one virulence gene and 34% did not show any virulence gene. H. pylori infection showed significant increase with age. H. pylori are prevalent amid dyspeptic patients in our region. The main genotype combinations were vacA+/cagA+ of s1m1 genotype and they were frequently associated with peptic ulcer diseases, gastritis, and gastroesophageal reflux disease.


2015 ◽  
Vol 12 (2) ◽  
pp. 36-41 ◽  
Author(s):  
Narayan Thapa ◽  
Kunda Bikram Shah ◽  
Bharat Bahadur Bhandari ◽  
Bhairab Kumar Hamal ◽  
Amar Shrestha ◽  
...  

Introduction: Helicobacter pylori (H. Pylori) as a primary etiological factor in carcinoma stomach. Associationof H. Pylori in gastric cancer has been documented to be in more than 50% of cases. In underdevelopedcountries, this association is shown to be much higher according to different studies.Methods: A prospective observational study of 40 consecutive cases of carcinoma stomach was under takenin surgical department of Shree Birendra hospital and Bir hospital, for a period of two years 2009 to 2011.Location and pathological types of the lesion were noted and all specimens were investigated to see presenceof helicobacter pylori by rapid urease test (RUT) and histological examination.Results: Out of 40 patients, helicobacter pylori positivity was seen in 27 (67.5%) cases by both rapid ureasetest and Histopathological examination (HPE). Regarding the pathological types, out of 26 intestinal type of castomach, 20 (76.92%) cases were positive for H. pylori infection, whereas out of 14 diffuse type of ca stomach,7(50%) cases were positive for H. pylori. In 29 cases of distal ca stomach, H. pylori positivity was seen in 22(75.86%) cases, whereas in rest of the 11 cases the lesion involved other part of the stomach, H. pylori positivitywas seen in 5(45.45%) cases.Conclusion: Helicobacter pylori infection is higher in prevalence in cases of stomach cancer. Its associationwith intestinal histological type of stomach cancer is more common than diffuse type. There is higher prevalenceof Helicobacter pylori infection in distal carcinoma. doi: http://dx.doi.org/10.3126/mjsbh.v12i2.12927


2018 ◽  
Vol 6 (2) ◽  
pp. 16-19
Author(s):  
Shatdal Chaudhary ◽  
Altaban Rahi ◽  
Anita Shah ◽  
Aakash Shahi ◽  
Badri Kumar Gupta ◽  
...  

Introduction: Helicobacter pylori (H. pylori) is a microaerophile gram-negative bacillus which is found mainly on the surface of mucous membrane of the prepyloric part of the stomach. It is found to be infecting approximately 50% of world population. In patients with liver cirrhosis, the prevalence of H. pylori is variable. A high incidence of H. pylori colonization has been found in portal hypertension; especially in those with gastric erosion. This study was done to find out the prevalence of H. pylori infection in patients with portal hypertension at Universal College of Medical Sciences Teaching Hospital, Nepal.  Materials and methods: It was a hospital based cross sectional observational study. All the consecutive patients aged more than 16 years, presented with portal hypertension who fulfilled the inclusion criteria were included in the study. The study period was from 1st  September 2015 to 31st August 2016. The upper gastrointestinal endoscopy was done in all cases and mucosal biopsy was taken. H. pylori infection was diagnosed by using rapid urease test.  Results: During the study period, 71 patients fulfilled the inclusion criteria and were included in the analysis. The majority of the patients 21 (29.6%) were between 51-60 years age group. There were more male (78.9%) then female (21.1%). The mean age of study population was 50.85 ± 12.47 years. Among the study population, rapid urease test was positive in 70.4% (n=50) patients.  Conclusion: The prevalence of H. pylori infection was seen in 70.4% of the patients suffering with portal hypertension. 


2019 ◽  
Vol 6 (12) ◽  
pp. 4294
Author(s):  
Ayathu V. S. Sai Mahesh ◽  
Shyam Sundar Tandri

Background: Gastritis is one of the commonest clinical conditions encountered by a physician. The most common cause is said to be infection with Helicobacter pylori. The present study was aimed to diagnose the prevalence of H. pylori infection among the cases of gastritis and its correlation with histopathological findings and associated rapid urease test.Methods: A one year prospective study at a tertiary care hospital was conducted and all cases of gastritis were included and socio demographic data, clinical complaints and duration were noted. Endoscopy was performed on all cases. Biopsy was performed histopathological examination with staining and graded by Houston-updated Sydney system. Rapid urease test was performed and findings noted.Results: 325 cases with 215 male and 110 female cases were included. 26.15% were in age group of more than 60 years and number of cases increased with age. Mean age of study participants was 39.12±2.8 years and heart burn was the common complaint in the study cases. 81.54% of the cases revealed endoscopic gastritis on endoscopy and hyperaemia was commonest. 83.69% were positive by rapid urease test. Rapid urease test is more sensitive than histological staining in confirmation of H. pylori infection.Conclusions: To conclude on the present study, the prevalence of H. pylori infection is on a global rise and appropriate measures to reduce the prevalence is quite an urgent necessity. Histopathological interpretation of gastric biopsies is a reliable indicator of H. pylori infection as well as gastritis grading according to the Sydney grading system.


2010 ◽  
Vol 5 (3) ◽  
pp. 257-258 ◽  
Author(s):  
Angelo Zullo ◽  
Cesare Hassan ◽  
Silvia Trapani ◽  
Gianfranco Tammaro

2020 ◽  
Vol 29 (3) ◽  
pp. 59-64
Author(s):  
Hanaa M. El Maghraby ◽  
Samar Mohaseb

Background: Metronidazole is one of the antimicrobial drugs that can be used in combination with other drugs for eradication of Helicobacter pylori (H. pylori).Unfortunately, metronidazole resistance in H. plori is an increasing health problem which may be attributed to inactivation of many genes as rdx A gene. Objective: To determine the frequency of rdx A deletion mutation in H. pylori detected in infected patients attending at the Gastroenterology Unit, Zagazig University Hospitals. Methodology: Two gastric biopsies were taken from each enrolled patient by endoscopy. H.pylori detection was done by rapid urease test and polymerase chain reaction (PCR) amplification of 16S rRNA gene. Deletion mutation in rdx A gene was detected by conventional PCR. Results: Out of 134 doubled gastric biopsies obtained from 134 patients, 52.2% were positive for H. pylori. Epigastric pain, vomiting and gastritis were significantly associated with detection of H. pylori infection (p˂ 0.05). Deletion mutation of rdx A gene was detected in 28.6% of H. pylori positive specimens obtained from infected patients. Conclusion: Deletion mutation of rdx A gene is a frequent determinant of rdx A inactivation conferring metronidazole resistance among H. pylori.


1999 ◽  
Vol 6 (1) ◽  
pp. 17-23 ◽  
Author(s):  
Minoru Kawaguchi ◽  
Toshihiko Saito

We determined the incidence of gastric metaplasia in the duodenal bulb of duodenal ulcer patients and the Helicobacter pylori (H. pylori) infection rate at sites with gastric metaplasia. Biopsy of the duodenal bulb showed the presence of gastric metaplasia in 61 of 86 patients (71%) overall and in 18 of 47 patients (38.3%) who had gastrectomy at an early gastric cancer. The histological diagnosis of H. pylori infection showed good agreement (83.3%) with the result of the rapid urease test, indicating that H. pylori occurs in regions with gastric metaplasia. This finding suggests that H. pylori infects gastric metaplasia in the duodenal bulb, causing mucosal injury, which is then transformed into duodenal ulcers. The exact mechanism by which gastric metaplasia is caused is unknown, but it is believed to occur in the transitional zone in the duodenal mucosa.


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