Portal Hypertensive Gastropathy

Pérez-Ayuso, R.M.; Piqué, J.M.

doi:10.1159/000171313

Cited by 8 publications

(3 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, gastric mucosal lesions are another frequent cause of upper gastrointestinal bleeding in these patients, accounting for 20% to 40% ofbleeds (1-5). Because McCormack et al (6), introduced the term congestive gastropathy, these mucosal lesions has been termed congestive gastropathy or portal-hypertensive gastropathy (PHG) ( 1 [7][8][9][10][11][12].…”

mentioning

confidence: 99%

Portal and gastric mucosal hemodynamics in cirrhotic patients with portal-hypertensive gastropathy

et al. 1994

View full text Add to dashboard Cite

Controversy exists as to the nature of gastric perfusion in portal-hypertensive gastropathy. To investigate portal hemodynamics and gastric mucosal perfusion in cirrhotic patients with and without portal-hypertensive gastropathy, we subjected 56 cirrhotic patients with portal hypertension to portal vein catheterization, pneumatic pressure sensor technique, duplex sonography and laser Doppler flowmetry. Thirteen patients had portal-hypertensive gastropathy: In 10 it was mild, and in 3 it was severe. The presence of portal-hypertensive gastropathy seemed to be independent of age, sex, cause of cirrhosis or grade of esophageal varices. Portal venous pressure, esophageal variceal pressure, portal venous flow and congestion index in patients with portal-hypertensive gastropathy were not significantly different from the values in those without portal-hypertensive gastropathy. However, portal-variceal pressure gradient (subtracting esophageal variceal pressure from portal venous pressure) (p < 0.01) and the incidence of palisading-type esophageal varices on portography (p < 0.05) was increased in patients with portal-hypertensive gastropathy significantly more than in those without portal-hypertensive gastropathy. In the fundus, gastric mucosal blood flow was significantly higher in patients with portal-hypertensive gastropathy than in those without portal-hypertensive gastropathy, whereas in the corpus and the antrum the values were not significantly different. We suggest that the mucosa of the upper stomach in patients with portal-hypertensive gastropathy is congestive and highly perfused. The pathogenesis of portal-hypertensive gastropathy may be related to both congestion and hyperemia in the upper stomach.

show abstract

mentioning

confidence: 99%

Portal and gastric mucosal hemodynamics in cirrhotic patients with portal-hypertensive gastropathy

et al. 1994

View full text Add to dashboard Cite

show abstract

“…In fact, although endoscopic appearance may be similar, chronic gastritis can be succesfully treated with gastroprotective or antisecretory drugs with or without activity against II. pylori [30], while poor results are reported in congestive gastropathy [31]. Our results sug gest that the different effects of therapy reflect differences in the pathophysiology of the two conditions.…”

Section: Discussionmentioning

confidence: 64%

“…pylori infection no more fre quent than in normal subjects. Thus, as already suggested [23,31,32], treatment should be carried out with drugs able to reduce blood perfusion, such as (5-blockers, rather than with acid inhibitors or cytoprotective agents.…”

mentioning

confidence: 99%

Congestive Gastropathy versus Chronic Gastritis: A Comparison of Some Pathophysiological Aspects

et al. 1993

View full text Add to dashboard Cite

In order to investigate some pathophysiological aspects of the two diseases, 15 patients with congestive gastropathy and 15 with chronic gastritis have been studied and compared with 15 healthy controls. Gastric blood flow as determined during endoscopy by means of laser Doppler flowmetry was found to be significantly increased (p < 0.001) in congestive gastropathy, whereas a significant reduction (p < 0.001) was noted in chronic gastritis. On the other hand, Helicobacter pylori was detected in 80% of cases in chronic gastritis, while the prevalence of the microorganism in congestive gastritis was similar to that in healthy controls. It is concluded that chronic gastritis and congestive gastropathy are related to different pathogenetic factors and require different therapeutic approaches.

show abstract

Treatment of bleeding from portal hypertensive gastropathy by portacaval shunt

Orloff

et al. 1995

Hepatology

View full text Add to dashboard Cite

Portal hypertensive gastropathy is a vascular disorder of the gastric mucosa distinguished by ectasia of the mucosal capillaries and submucosal veins without inflammation. During 1988 to 1993, 12 patients with biopsy-proven cirrhosis (10 alcoholic, 2 posthepatitic) were evaluated and treated prospectively by portacaval shunt for active bleeding from severe portal hypertensive gastropathy. Eleven patients had been hospitalized for bleeding three to nine times previously, and one was bleeding uncontrollably for the first time. Requirement for blood transfusions ranged from 11 to 39 units cumulatively, of which 8 to 30 units were required specifically to replace blood lost from portal hypertensive gastropathy. Admission findings were ascites in 9 patients, jaundice in 8, severe muscle wasting in 10, hyperdynamic state in 9. Child's risk class was C in 7, B in 4, A in 1. Ten of the 12 patients had previously received repetitive endoscopic sclerotherapy for esophageal varices, which has been reported to precipitate portal hypertensive gastropathy. Eight patients had failed propranolol therapy for bleeding. Portacaval shunt was performed emergently in 11 patients and electively in 1, and permanently stopped bleeding in all by reducing the mean portal vein-inferior vena cava pressure gradient from 251 to 16 mm saline. There were no operative deaths, and two unrelated late deaths after 13 and 24 months. During 1 to 6.75 years of follow-up, all shunts remained patent by ultrasonography, the gastric mucosa reverted to normal on serial endoscopy, and there was no gastrointestinal bleeding. Recurrent portal-systemic encephalopathy developed in only 8% of patients. Quality of life was generally good.(ABSTRACT TRUNCATED AT 250 WORDS)

show abstract

Portal Hypertensive Gastropathy

Cited by 8 publications

References 15 publications

Portal and gastric mucosal hemodynamics in cirrhotic patients with portal-hypertensive gastropathy

Portal and gastric mucosal hemodynamics in cirrhotic patients with portal-hypertensive gastropathy

Congestive Gastropathy versus Chronic Gastritis: A Comparison of Some Pathophysiological Aspects

Treatment of bleeding from portal hypertensive gastropathy by portacaval shunt

Contact Info

Product

Resources

About