What is Portal Hypertension Gastropathy?

Portal Hypertension Gastropathy

refers to the changes in the cells of the stomach lining due to portal hypertension. Hypertension would simply mean high blood pressure. In this particular case, it is referred to the pressure in the portal vein of the liver. The hepatic portal vein is a blood vessel in the abdomen which directs blood from the gastrointestinal tract and spleen into the liver.
The condition is characterized by the snake skin like appearance of the mucous lining of the stomach revealed through an endoscopic procedure. The surface of the stomach lining becomes friable and is prone to get cracked. The patients have dilated arteries and venules ( very small veins). This condition affects mostly the first 2/3 of the stomach and is seen in the fundus and cardia of the stomach. It rarely affects the antrum or the last 1/3 of the stomach.
Portal hypertension is a common symptom in patients with cirrhosis of liver. About 25% of patients with cirrhosis develop portal hypertension. And 50% of patients with portal hypertension develops the discussed condition.

Portal Hypertension Gastropathy

The main symptom of

Portal Hypertension Gastropathy

is gastrointestinal bleeding which may lead to blood vomit or melena(foul smelling tarry black stools).

Treatment of Portal Hypertension Gastropathy

  • Usage of beta blockers:

    Beta blockers like Propranolol and Nadolol have been used to bring down the high blood pressure in the portal vein. It has been successfully used on patients of esophageal and stomach varices where abnormal dilation of blood vessels cause bleeding.

  • Usage of Anti-Fibrinolytic Medication:

    This kind of drugs like the Tranexamic Acid works by depositing fibrin on the bleeding sites and stopping the blood loss.

  • Usage of Octreotide:

    This medication is used to reduce the flow of blood directed to the liver thereby bringing down the resultant portal hypertension.

  • Argon Plasma Coagulation:

    An endoscopic procedure is used. The probe is used to introduce argon gas from a distance to the bleed spot. The argon gas is ionized using a high voltage discharge. High frequency electric current is then made to pass through a jet of gas and this results in coagulation of the bleeding lesion.

  • Using Portosystemic Shunt:

    In this procedure surgically an artificial connection is established between the portal vein and the low pressure outflow hepatic vein. The hypertension in the portal vein is greatly relieved.

  • Cryotherapy:

    In this procedure, carbon dioxide under extreme pressure is introduced through the endoscope in to the abdomen to freeze and destroy bleeding tissue.

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