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Review
. 2019 Nov;23(4):643-658.
doi: 10.1016/j.cld.2019.07.002. Epub 2019 Aug 30.

An Update: Portal Hypertensive Gastropathy and Colopathy

Don C Rockey  1
Affiliations
Review

An Update: Portal Hypertensive Gastropathy and Colopathy

Don C Rockey. Clin Liver Dis. 2019 Nov.

Abstract

Complications of portal hypertension include portal hypertensive gastropathy and colopathy. These disorders may cause chronic or acute gastrointestinal bleeding. The diagnosis is made endoscopically; therefore, there is great variability in their assessment. Portal hypertensive gastropathy can range from a mosaic-like pattern resembling snakeskin mucosa to frankly bleeding petechial lesions. Portal hypertensive colopathy has been less well-described and is variably characterized (erythema, vascular lesions, petechiae). Treatment is challenging and results are inconsistent. Currently, available evidence does not support the use of beta-blockers for primary prevention. Further investigation of the pathogenesis, natural history, and treatment of these disorders is needed.

Keywords: Bleeding; Cirrhosis; Hemorrhage; Portal hypertension; Pressure.

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Conflict of interest statement

Disclosure of Conflicts

The author certifies that he have no financial arrangements (e.g., consultancies, stock ownership, equity interests, patent-licensing arrangements, research support, major honoraria, etc.).

Figures

Figure 1.
Figure 1.. Endoscopic images of PHG.
For comparison, normal gastric mucosa is seen in image A, while mild PHG is visualized in B, and C. Severe PHG is seen in image D, including evidence of bleeding. From Urrunaga, N. H. Rockey, D. C.. Portal hypertensive gastropathy and colopathy. Clin Liver Dis. 2014.
Figure 2.
Figure 2.. PHG management.
Recommended approaches to therapy are shown. PHC is managed similarly. Adapted from Urrunaga, N. H. Rockey, D. C.. Portal hypertensive gastropathy and colopathy. Clin Liver Dis. 2014.
See this image and copyright information in PMC

References

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