Assuntos
Carcinoma de Células Escamosas/complicações , Transtornos de Deglutição/tratamento farmacológico , Endoscopia do Sistema Digestório/métodos , Neoplasias Esofágicas/complicações , Etanol/uso terapêutico , Adenocarcinoma/complicações , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Transtornos de Deglutição/etiologia , Etanol/administração & dosagem , Etanol/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Hepatic venous catheterisation and transvenous liver biopsy were performed in five patients with hepatic amyloidosis. In three patients, hepatic venous pressures were normal and histological examination of the liver biopsy specimen showed discrete and sparse perisinusoidal amyloid deposits. In the other two, however, the gradient between wedged and free hepatic venous pressures was increased (12 and 16 mmHg; normal 1-4 mmHg) and amyloid deposits were abundant and diffuse in the Disse's space. This study shows that portal hypertension in patients with hepatic amyloidosis is of the sinusoidal type and is related to the reduction of vascular space of hepatic sinusoids by massive perisinusoidal amyloid deposits. Furthermore, portal hypertension is associated with a poor prognosis in patients with hepatic amyloidosis.