Approach to the management of portal hypertensive gastropathy and gastric antral vascular ectasia

Gastroenterol Clin North Am. 2014 Dec;43(4):835-47. doi: 10.1016/j.gtc.2014.08.012. Epub 2014 Sep 20.

Abstract

Gastric antral vascular ectasia (GAVE) and portal hypertensive gastropathy (PHG) are important causes of chronic gastrointestinal bleeding. These gastric mucosal lesions are mostly diagnosed on upper endoscopy and can be distinguished based on their appearance or location in the stomach. In some situations, especially in patients with liver cirrhosis and portal hypertension, a diffuse pattern and involvement of gastric mucosa are seen with both GAVE and severe PHG. The diagnosis in such cases is hard to determine on visual inspection, and thus, biopsy and histologic evaluation can be used to help differentiate GAVE from PHG.

Keywords: GI bleeding; Liver cirrhosis; Portal hypertension; Transjugular intrahepatic portosystemic shunt (TIPS).

Publication types

  • Review

MeSH terms

  • Argon Plasma Coagulation
  • Endoscopy, Gastrointestinal
  • Gastric Antral Vascular Ectasia / complications
  • Gastric Antral Vascular Ectasia / diagnosis
  • Gastric Antral Vascular Ectasia / epidemiology
  • Gastric Antral Vascular Ectasia / therapy*
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / therapy*
  • Hemostasis, Endoscopic*
  • Humans
  • Hypertension, Portal / complications*
  • Ligation
  • Liver Cirrhosis / complications