Management of gastropathy and gastric vascular ectasia in portal hypertension.
Portal hypertensive gastropathy and gastric antral vascular ectasia may cause gastrointestinal hemorrhage in patients with portal hypertension. Whereas the former presents exclusively in patients with portal hypertension, gastric antral vascular ectasia can also be observed in patients with other conditions. Diagnosis is established with upper gastrointestinal endoscopy, although some cases may require a biopsy to confirm the diagnosis. The most frequent manifestation is ferropenic anemia, which may become transfusion dependent. Treatment in portal hypertensive gastropathy is focused on portal pressure reducing drugs, mainly nonselective beta-blockers, whereas in gastric antral vascular ectasia treatment is based on endoscopic ablation. More invasive options can be used if first-line therapies fail, although these should be evaluated on a case-by-case basis.
Ripoll
Cristina
C
Department of Digestive Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Garcia-Tsao
Guadalupe
G
D055011:Ablation Techniques / Q000009:adverse effects / Q000379:methods; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D001706:Biopsy / Q000009:adverse effects / Q000379:methods; D001803:Blood Transfusion; D020776:Endoscopes, Gastrointestinal; D020252:Gastric Antral Vascular Ectasia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D006975:Hypertension, Portal / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D008103:Liver Cirrhosis / Q000150:complications / Q000503:physiopathology; D013272:Stomach Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists