title: Portal hypertensive gastropathy with a focus on management.
abstract: Portal hypertensive gastropathy (PHG) is a painless condition of gastric mucosal ectasia and impaired mucosal defense, commonly seen in patients with elevated portal pressures. While it is typically asymptomatic and incidentally discovered on upper endoscopy, acute and chronic bleeding may occur. There are no definitive recommendations for treatment of asymptomatic PHG. Non-selective β-blockers represent the mainstay of therapy for chronic bleeding, while somatostatin and vasopressin and their derivatives may be used in conjunction with supportive measures for acute bleeding. Salvage therapy with transjugular intrahepatic portosystemic shunt or rarely surgical shunt is appropriate when medical management fails. The role of endoscopic therapy for PHG is controversial. Liver transplantation should be considered as a final resort in cases of refractory bleeding due to PHG.
authors: a 1 New York University Medical School, 550 1st Avenue, New York, NY 10016, USA.
authors: Patrick
authors: P
authors: Snyder
authors: Rabia
authors: R
authors: Ali
authors: Michael
authors: M
authors: Poles
authors: Seth A
authors: SA
authors: Gross
mesh_terms: D000208:Acute Disease; D058070:Asymptomatic Diseases; D002908:Chronic Disease; D005753:Gastric Mucosa / Q000473:pathology*; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D013272:Stomach Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy
keywords: anemia; cirrhosis; congestive gastropathy; hemorrhage; portal hypertension; portal hypertensive gastropathy