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Portal hypertensive gastropathy.

L Negreanu1, C Buşegeanu, D Trandafir

  • 1Internal Medicine and Gastroenterology Clinic, University Hospital, Bucharest, Romania. negreanu_99@yahoo.com

Romanian Journal of Internal Medicine = Revue Roumaine De Medecine Interne
|June 3, 2006
PubMed
Summary

Portal hypertensive gastropathy (PHG) presents a mosaic-like pattern in the stomach, affecting 50-98% of patients with portal hypertension. It is a significant cause of upper digestive hemorrhage in cirrhotic patients.

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Area of Science:

  • Gastroenterology
  • Hepatology
  • Endoscopy

Background:

  • Portal hypertensive gastropathy (PHG) is an endoscopic finding in patients with portal hypertension, characterized by a mosaic-like pattern.
  • Its prevalence varies widely (50-98%), potentially due to diagnostic criteria and observer variability.
  • PHG accounts for approximately 8% of upper gastrointestinal bleeding in cirrhotic patients.

Purpose of the Study:

  • To review the endoscopic findings, prevalence, and current understanding of portal hypertensive gastropathy.
  • To discuss the pathogenesis and therapeutic options for PHG.

Main Methods:

  • Literature review of studies on portal hypertensive gastropathy.
  • Analysis of endoscopic classifications and reported prevalence rates.

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  • Summary of current treatment modalities.

    • Main Results:

    • PHG exhibits a characteristic mosaic pattern, with or without red spots, in the gastric mucosa.
    • Portal hypertension, not liver disease severity, is the primary driver of PHG.
    • Gastric Antral Vascular Ectasia (GAVE) is a distinct endoscopic finding.

    Conclusions:

    • PHG is a common endoscopic finding in portal hypertension with significant bleeding potential.
    • Further standardization of classification and understanding of pathogenesis are needed.
    • Treatment options range from medical management to surgical interventions and liver transplantation.