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Portal Hypertensive Gastropathy

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Variceal Bleeding in Liver Cirrhosis

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Abstract

Portal hypertension patients with or without cirrhosis commonly experience two distinct forms of gastric mucosal abnormalities: portal hypertensive gastropathy (PHG) and gastric vascular antral ectasia (GAVE). The morbidity and mortality risks associated with PHG are highly underestimated. Variceal bleeding is correlated with 39.1% mortality rate while PHG is associated with 12.5% mortality rate; neither is considered benign. These mortality and morbidity rates are significantly associated with two main factors: chronic blood loss anemia and repeated hospitalizations for insignificant small bleeding. Clinical features of PHG and GAVE, such as gastrointestinal hemorrhage, can result in sudden death and therefore require significant attention. It is imperative to precisely identify the timing of the first initial screening used to identify high-risk individuals. Several tools are available to assess the presence, severity, and complexity of PHG. Additionally, treatment options are available to prevent secondary bleeding and control of blood loss anemia. The mainstay therapy for chronic bleeding is nonselective β-blockers, while vasopressin, somatostatin, and their derivatives are used in cases of acute bleeding.

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I acknowledge and appreciate administrative and editorial help of Mohammad Habib and Farah Alsafar.

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  1. Liver Institute PLLC, Tucson, AZ, USA

    Shahid Habib

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  1. General Hospital of Northern Theater Command, Shenyang, Liaoning, China

    Xiaozhong Guo

  2. General Hospital of Northern Theater Command, Shenyang, Liaoning, China

    Xingshun Qi

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Habib, S. (2021). Portal Hypertensive Gastropathy. In: Guo, X., Qi, X. (eds) Variceal Bleeding in Liver Cirrhosis. Springer, Singapore. https://doi.org/10.1007/978-981-15-7249-4_8

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