Water and electrolyte movement and mucosal morphology in the jejunum of patients with portal hypertension

D. A. Norman, James M Atkins, L. L. Seelig, C. Gomez-Sanchez, G. J. Krejs

Research output: Contribution to journalArticle

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Abstract

Intestinal secretion and intercellular space dilatation can be induced in animal models by acute elevation of intravascular volume or portal pressure. We examined whether patients with increased portal venous pressure might represent a clinical counterpart to these animal models. Portal venous pressure, determined by hepatic wedge pressure measurement, was elevated to 10-55 mmHg (mean 29 mmHg) in 8 patients with chronic liver disease without diarrhea. Intestinal transport studies utilizing a steady-state perfusion technique revealed normal absorption of a plasma like electrolyte solution. A solution designed to unmask intestinal secretion demonstrated no difference from control subjects in the movement of water, electrolytes, or protein into the intestinal lumen. There was no correlation of absorption or secretion with hepatic wedge pressure. Jejunal biopsy revealed a significant increase in dilatation of intercellular spaces in patients compared to controls; this increase was not correlated with hepatic wedge pressure, but was significantly inversely correlated to plasma renin and aldosterone concentration. We conclude that patients with chronic liver disease and portal hypertension absorb water and electrolytes normally, but have mild morphologic alterations in the intestinal mucosa, possibly related to intravascular volume status.

Original languageEnglish (US)
Pages (from-to)707-715
Number of pages9
JournalGastroenterology
Volume79
Issue number4
StatePublished - 1980

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Water Movements
Portal Hypertension
Jejunum
Portal Pressure
Electrolytes
Pulmonary Wedge Pressure
Intestinal Secretions
Extracellular Space
Liver Diseases
Dilatation
Liver
Chronic Disease
Animal Models
Intestinal Mucosa
Aldosterone
Renin
Diarrhea
Perfusion
Biopsy
Water

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Norman, D. A., Atkins, J. M., Seelig, L. L., Gomez-Sanchez, C., & Krejs, G. J. (1980). Water and electrolyte movement and mucosal morphology in the jejunum of patients with portal hypertension. Gastroenterology, 79(4), 707-715.

Water and electrolyte movement and mucosal morphology in the jejunum of patients with portal hypertension. / Norman, D. A.; Atkins, James M; Seelig, L. L.; Gomez-Sanchez, C.; Krejs, G. J.

In: Gastroenterology, Vol. 79, No. 4, 1980, p. 707-715.

Research output: Contribution to journalArticle

Norman, DA, Atkins, JM, Seelig, LL, Gomez-Sanchez, C & Krejs, GJ 1980, 'Water and electrolyte movement and mucosal morphology in the jejunum of patients with portal hypertension', Gastroenterology, vol. 79, no. 4, pp. 707-715.
Norman, D. A. ; Atkins, James M ; Seelig, L. L. ; Gomez-Sanchez, C. ; Krejs, G. J. / Water and electrolyte movement and mucosal morphology in the jejunum of patients with portal hypertension. In: Gastroenterology. 1980 ; Vol. 79, No. 4. pp. 707-715.
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