Peroral biopsy of the intestinal mucosa in hepatic cirrhosis

Conclusions

From observations, we conclude that in hepatic cirrhosis the duodenal and jejunal mucosa demonstrate the following profound alterations: (1) intense stasis, especially in the axis of the villus; (2) edema of the villus, with degeneration of the basement membrane and separation of the epithelium from the stroma; (3) degeneration of epithelium and stroma; (4) interstitial inflammation (small round-cell infiltration); (5) fibrous replacement of the stroma; (6) destruction of the walls of the vessels; and (7) dilatation of the crypts of Galeazzi-Lieberkühn, with degeneration and atrophy of the cryptic epithelium and fibrosis.

It is conceivable that these alterations taken together follow one another in the sequence described. The stasis of the intestinal mucosa might indeed result from portal stasis. This could be the fundamental cause of the alterations. Although this interpretation seems reasonable to us we cannot completely subscribe to it, because we have not excluded the possibility that the mucosa may have been damaged by the same factors that cause cirrhosis. Study of cases less advanced may clarify the mechanism of development of these lesions.