Gastropathy and Gastritis in Children With Portal Hypertension

El-Rifai, Nahida; Mention, Karine; Guimber, D.; Michaud, Laurent; Boman, Françoise; Turck, Dominique; Gottrand, Frédéric

doi:10.1097/mpg.0b013e318049cbe2

Cited by 15 publications

(10 citation statements)

References 18 publications

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“…13.2; P < 0.0003) [34] . Numerous other studies also demonstrated significant correlation between presence of esophageal varices and PHG, and several studies also demonstrated significant correlations between variceal size and PHG [9,13,29,42,56,57,62] . For example, Abbasi et al [62] reported that esophageal variceal size was significantly correlated with PHG frequency among 217 cirrhotic patients (r = 0.46; P < 0.001).…”

Section: Liver Disease Durationmentioning

confidence: 99%

“…Itha et al [11] EHPVO in children 163 (12%) Not reported Not reported Rana et al [12] Portal hypertension 41 27 (66%) 19 (46%) 8 (20%) El-Rifai et al [13] Portal hypertension 24 14 (58%) 10 (42%) -moderate 4 (16%) Sogaard et al [14] Portal vein thrombosis 67 28 (42%) Not reported Not reported Figueiredo et al [15] Portal hypertension; cirrhosis 36 27 (75%) 5 (46%) Erden et al [16] Portal hypertension 57 15 (26.3%) Not reported Not reported Duché et al [17] Children, portal hypertension with biliary atresia 125 …”

Section: Not Reported Not Reportedmentioning

confidence: 99%

“…The reported prevalence of PHG varies greatly from 20% to 75% in patients with portal hypertension (Table 1) [3,[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] , and varies greatly from about 35% to 80% in patients with cirrhosis (Table 2) [21, . For example, in a study of 373 cirrhotic patients, 299 (80.2%) had PHG [34] .…”

Section: Epidemiologymentioning

confidence: 99%

“…Cirrhosis etiology: Several research groups reported that the underlying etiology of cirrhosis did not affect PHG frequency or severity [13,71,80] . For example, Abbasi et al [62] reported among 217 patients with cirrhosis that PHG was unassociated with cirrhosis etiology (r = 0.056; P = 0.414), among 144 patients with hepatitis C, 36 patients with hepatitis B, 21 patients with cryptogenic cirrhosis, 15 patients with hepatitis C and hepatitis B coinfection, and 1 patient with hepatitis B and hepatitis D coinfection.…”

Section: Cirrhotic Vs Non-cirrhotic Portal Hypertensionmentioning

confidence: 99%

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Portal hypertensive gastropathy: A systematic review of the pathophysiology, clinical presentation, natural history and therapy

Gjeorgjievski¹

2016

WJH

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AIM:To describe the pathophysiology, clinical presentation, natural history, and therapy of portal hypertensive gastropathy (PHG) based on a systematic literature review. METHODS:Computerized search of the literature was performed via PubMed using the following medical subject headings or keywords: "portal" and "gastropathy"; or "portal" and "hypertensive"; or "congestive" and "gastropathy"; or "congestive" and "gastroenteropathy". The following criteria were applied for study inclusion: Publication in peer-reviewed journals, and publication since 1980. Articles were independently evaluated by each author and selected for inclusion by consensus after discussion based on the following criteria: Well-designed, prospective trials; recent studies; large study populations; and study emphasis on PHG. RESULTS:PHG is diagnosed by characteristic endoscopic findings of small polygonal areas of variable erythema surrounded by a pale, reticular border in a mosaic pattern in the gastric fundus/body in a patient with cirrhotic or non-cirrhotic portal hypertension. Histologic findings include capillary and venule dilatation, congestion, and tortuosity, without vascular fibrin thrombi or inflammatory cells in gastric submucosa. PHG is differentiated from gastric antral vascular ectasia by a different endoscopic appearance. The etiology of PHG is inadequately understood. Portal hypertension is necessary but insufficient to develop PHG because many patients have portal hypertension without PHG. Portal hypertensive gastropathy: A systematic review of the pathophysiology, clinical presentation, natural history and therapy PHG increases in frequency with more severe portal hypertension, advanced liver disease, longer liver disease duration, presence of esophageal varices, and endoscopic variceal obliteration. PHG pathogenesis is related to a hyperdynamic circulation, induced by portal hypertension, characterized by increased intrahepatic resistance to flow, increased splanchnic flow, increased total gastric flow, and most likely decreased gastric mucosal flow. Gastric mucosa in PHG shows increased susceptibility to gastrotoxic chemicals and poor wound healing. Nitrous oxide, free radicals, tumor necrosis factor-alpha, and glucagon may contribute to PHG development. Acute and chronic gastrointestinal bleeding are the only clinical complications. Bleeding is typically mild-to-moderate. Endoscopic therapy is rarely useful because the bleeding is typically diffuse. Acute bleeding is primarily treated with octreotide, often with concomitant proton pump inhibitor therapy, or secondarily treated with vasopressin or terlipressin. Nonselective β-adrenergic receptor antagonists, particularly propranolol, are used to prevent bleeding after an acute episode or for chronic bleeding. Iron deficiency anemia from chronic bleeding may require iron replacement therapy. Transjugular-intrahepaticportosystemic-shunt and liver transplantation are highly successful ultimate therapies because they reduce the underlying portal hypertension. SYSTEMA...

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Section: Liver Disease Durationmentioning

confidence: 99%

Section: Not Reported Not Reportedmentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

Section: Cirrhotic Vs Non-cirrhotic Portal Hypertensionmentioning

confidence: 99%

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Portal hypertensive gastropathy: A systematic review of the pathophysiology, clinical presentation, natural history and therapy

Gjeorgjievski¹

2016

WJH

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“…Several retrospective studies suggest that PPIs may increase the risk of bacterial infection in this population [84]. In children, however, gastritis is frequently associated with portal hypertension [85]. …”

Section: Reviewmentioning

confidence: 99%

Management by the intensivist of gastrointestinal bleeding in adults and children

et al. 2012

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Intensivists are regularly confronted with the question of gastrointestinal bleeding. To date, the latest international recommendations regarding prevention and treatment for gastrointestinal bleeding lack a specific approach to the critically ill patients. We present recommendations for management by the intensivist of gastrointestinal bleeding in adults and children, developed with the GRADE system by an experts group of the French-Language Society of Intensive Care (Société de Réanimation de Langue Française (SRLF), with the participation of the French Language Group of Paediatric Intensive Care and Emergencies (GFRUP), the French Society of Emergency Medicine (SFMU), the French Society of Gastroenterology (SNFGE), and the French Society of Digestive Endoscopy (SFED). The recommendations cover five fields of application: management of gastrointestinal bleeding before endoscopic diagnosis, treatment of upper gastrointestinal bleeding unrelated to portal hypertension, treatment of upper gastrointestinal bleeding related to portal hypertension, management of presumed lower gastrointestinal bleeding, and prevention of upper gastrointestinal bleeding in intensive care.

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Vaskuläre Erkrankungen

Stolte¹

2013

Pathologie

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Gastropathy and Gastritis in Children With Portal Hypertension

Cited by 15 publications

References 18 publications

Portal hypertensive gastropathy: A systematic review of the pathophysiology, clinical presentation, natural history and therapy

Portal hypertensive gastropathy: A systematic review of the pathophysiology, clinical presentation, natural history and therapy

Management by the intensivist of gastrointestinal bleeding in adults and children

Vaskuläre Erkrankungen

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