[Study of gastric mucosal lesion in portal hypertension]

An assessment has been made regarding the gastric mucosal lesion associated with portal hypertension clinically and histopathologically. Endoscopically, characteristic findings were those accompanied mainly by mucosal atrophy, red spots and hemorrhagic spots (portal hypertensive gastropathy: PHG). It was considered that rupture of the gastric mucosal defense factor is involved in portal hypertension as gastric acid secretion shows hypoacidity in the patients. The true form of portal hypertension is considered to be congestive gastropathy from the points that PHG is observed in high frequencies in the high portal pressure group, the severe esophageal varices group and group without gastrorenal or splenorenal shunt, that the mucosal blood flow rate in the lesion increased and that venectasia is present in the submucosal layer. Exacerbation of PHG was observed in the fundic area after EIS (endoscopic injection sclerotherapy), but no particularly large change was observed in the region after direct operation on esophageal varices. Administration of propranolol was effective for PHG.