Gastritis Varioliforme y Daño Hepático Crónico: Una Inesperada Asociación

Resumen

Background: Varioliform gastritis (VG) is found in aproximately 2 to 3% of upper gastrointestinal endoscopies. Its ethiology is not known. We have observed a higher frecuency of VG in patients with liver cirrhosis.

Aim: The objective of present study was to confirm that there is an association between VG and liver cirrhosis.

Subjects and methods: The design included two studies:(1)Retrospective, though the review of our endoscopies database. (2) Prospective, including all diagnosed cases in 13 months. Among all patients referred for upper gastrointestinal endoscopies, cases with the endoscopic diagnosis of VG were identified. In them, the presence of liver cirrhosis, based on clinic, laboratory, ultrasonographic and endoscopic features were registered.

Results: Out of 11659 upper gastrointestinal endoscopies, VG was found in 549 cases. In 794 cirrhotics there were 75 VG (9,4%) compared to 474 VG in 10865 patients without cirrhosis (4,4%), OR=2.25 (CI 1.73-2.93, p<.000). In the prospective study including 1498 upper gastrointestinal endoscopies, the same proportions were found, being VG significantly more frequent in patients with liver cirrhosis. According to the endoscopic findings of portal hypertension (esophageal varices or portal gastropathy), VG was significantly more frequent in patients with those features.

Conclusions: A higher frequency of VG was found in patients with liver cirrhosis. POrtal hypertension could be one of the factors involved in its pathogenesis. The clinical significance of these results resides in the recommendation that the endoscopic finding of VG should alert the physician to look for the presence of coexistent liver cirrhosis.