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Review
. 2014 Mar;20(1):1-5.
doi: 10.3350/cmh.2014.20.1.1. Epub 2014 Mar 26.

Management of portal hypertensive gastropathy and other bleeding

Woo Jin Chung  1
Affiliations
Review

Management of portal hypertensive gastropathy and other bleeding

Woo Jin Chung. Clin Mol Hepatol. 2014 Mar.

Abstract

A major cause of cirrhosis related morbidity and mortality is the development of variceal bleeding, a direct consequence of portal hypertension. Less common causes of gastrointestinal bleeding are peptic ulcers, malignancy, angiodysplasia, etc. Upper gastrointestinal bleeding has been classified according to the presence of a variceal or non-variceal bleeding. Although non-variceal gastrointestinal bleeding is not common in cirrhotic patients, gastroduodenal ulcers may develop as often as non-cirrhotic patients. Ulcers in cirrhotic patients may be more severe and less frequently associated with chronic intake of non-steroidal anti-inflammatory drugs, and may require more frequently endoscopic treatment. Portal hypertensive gastropathy (PHG) refers to changes in the mucosa of the stomach in patients with portal hypertension. Patients with portal hypertension may experience bleeding from the stomach, and pharmacologic or radiologic interventional procedure may be useful in preventing re-bleeding from PHG. Gastric antral vascular ectasia (GAVE) seems to be different disease entity from PHG, and endoscopic ablation can be the first-line treatment.

Keywords: Gastric antral vascular ectasia; Liver cirrhosis; Portal hypertensive gastropathy.

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Conflict of interest statement

The author has no conflicts to disclose.

Figures

Figure 1
Figure 1
Prevalence of gastrointestinal bleeding in patients with or without accompanying liver cirrhosis who visited emergency room at Keimyung university Dongsan hospital between Jan. 2010 and Dec. 2011. LC, liver cirrhosis.
Figure 2
Figure 2
Analysis of gastrointestinal bleeding causes in patients with or without accompanying liver cirrhosis who visited emergency room at Keimyung university Dongsan hospital between Jan. 2010 and Dec.2011. Prevalence of bleeding causes in patients without liver cirrhosis (A) and with liver cirrhosis (B). Prevalence of non-variceal bleeding causes in patients with liver cirrhosis (C). G. ulcer, Gastric ulcer; D. ulcer, Duodenal ulcer; G. Cancer, Gastric cancer; E. varix, Esophageal varix; G. varix, Gastric varix.
Figure 3
Figure 3
Representative images of mild (A) and severe (B) portal hypertensive gastropathy.
See this image and copyright information in PMC

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