Background: The endoscopic appearance of portal hypertensive intestinal vasculopathy is well described in the stomach, the jejunum, and the colon, but there is no description of changes that occur in the ileum.
Methods: The terminal ileum was intubated at colonoscopy in 44 patients with cirrhosis and portal hypertension and 46 control patients. Changes in the terminal ileum were noted. In addition, anorectal varices and colopathy were carefully noted and recorded.
Results: Ileal varices and/or portal hypertensive ileopathy were present in 16 of 44 (36%) patients with cirrhosis and portal hypertension but not in any control patient ( p < 0.01). Ileal varices were present in 8 patients (18%) with cirrhosis/portal hypertension and none of the control patients ( p < 0.05). Portal hypertensive ileopathy was noted in 11 patients (25%) with cirrhosis and portal hypertension and in none of the control patients ( p < 0.05). Ileal varices had no association with any other parameter studied. However, ileopathy was observed in 9 of the 23 patients with colopathy and in only two of the 21 patients without colopathy ( p < 0.05).
Conclusions: Ileal varices and mucosal changes of portal hypertensive ileopathy occur in patients with cirrhosis and portal hypertension. In the population studied, ileopathy was significantly more common in patients who had portal hypertensive colopathy.