title: Review article: the management of portal hypertensive gastropathy and gastric antral vascular ectasia in cirrhosis.
abstract: BACKGROUND
  Portal hypertensive gastropathy (PHG) and gastric antral vascular ectasia (GAVE) are important causes of both acute and chronic gastrointestinal bleeding in patients with cirrhosis.
  
  
  OBJECTIVE
  To review the current management of PHG and GAVE.
  
  
  METHODS
  PubMed was searched for English language articles using the key words 'GAVE', 'gastric antral vascular ectasia', 'cirrhosis', 'gastrointestinal bleeding', 'acute', 'chronic', 'portal hypertensive gastropathy', 'watermelon stomach', 'radiofrequency ablation', 'band ligation', 'thermoablation' and 'TIPSS'.
  
  
  RESULTS
  GAVE and PHG are both encountered in patients with cirrhosis. They can be seen in asymptomatic patients and in those with either acute or chronic gastrointestinal bleeding. PHG, by definition, requires the presence of portal hypertension, with or without cirrhosis, whereas GAVE requires neither cirrhosis nor portal hypertension. They can often be diagnosed on endoscopic appearance alone, but may require biopsy in certain cases. The treatment of PHG is aimed at reducing hepatic venous pressure gradients, most often by pharmacologic means, but may require shunt procedures in severe cases. Management of GAVE on the other hand is predominantly endoscopic, focusing on various ablative techniques.
  
  
  CONCLUSIONS
  Gastric antral vascular ectasia and portal hypertensive gastropathy are distinct entities and are both encountered in cirrhotic patients. Management of portal hypertensive gastropathy is centred on reduction in portal pressures, whereas treatment of gastric antral vascular ectasia is predominantly endoscopic.
authors.affiliation: Beth Israel Deaconess Medical Center, Boston, MA, USA.
authors.forename: V R
authors.initials: VR
authors.lastname: Patwardhan
authors.forename: A
authors.initials: A
authors.lastname: Cardenas
mesh_terms: D001706:Biopsy; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D020252:Gastric Antral Vascular Ectasia / Q000503:physiopathology / Q000628:therapy*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications* / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000150:complications; D017082:Portal Pressure; D013272:Stomach Diseases / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D014690:Venous Pressure