» Articles » PMID: 3781334

Portal Hypertensive Gastric Mucosa: an Endoscopic Study

Overview
Journal Gut
Specialty Gastroenterology
Date 1986 Oct 1
PMID 3781334
Citations 24
Authors
Affiliations
Soon will be listed here.
Abstract

The endoscopic features of the gastric mucosa in patients with cirrhosis have not been systematically investigated. In these patients, we observed an endoscopic aspect, consisting of multiple small erythematous areas, outlined by a subtle yellowish network (resembling a mosaic), mainly located in the proximal part of the stomach. We tested the value of this sign by comparing two groups: 100 patients with portal hypertension due to cirrhosis, and 300 control patients without signs of liver disease or portal hypertension. This endoscopic pattern was observed in 94 of the patients with cirrhosis, whereas oesophageal varices were seen in 78 only. In contrast, only one patient of the control group had this aspect. Moreover, this sign was also found in seven of eight patients with non cirrhotic portal hypertension, but was seen neither in 100 patients with chronic alcoholism but without liver disease, nor in 10 cirrhotic patients with end-to-side portacaval shunts. These endoscopic changes might be because of mucosal and/or submucosal oedema and congestion highlighting the normal areae gastricae pattern and related to raised portal pressure. We conclude that the mosaic pattern of the gastric mucosa is a sensible and specific sign for diagnosis of portal hypertension, whatever the cause.

Citing Articles

Infection in Cirrhotic Patients With Portal Hypertensive Gastropathy: A New Enigma?.

Alarfaj S, Mostafa S, Abdelsalam R, Negm W, El-Masry T, Hussein I Front Med (Lausanne). 2022; 9:902255.

PMID: 35801205 PMC: 9254718. DOI: 10.3389/fmed.2022.902255.


Gastric Antral Vascular Ectasia as the First Presentation of Primary Biliary Cholangitis.

Biswas S, Elhence A, Agrawal V, Ghoshal U Cureus. 2022; 14(1):e21676.

PMID: 35237475 PMC: 8882223. DOI: 10.7759/cureus.21676.


Postmarketing surveillance of rabeprazole in upper gastrointestinal peptic lesions in Japanese patients with coexisting hepatic disorders.

Makino I, Nakamura K, Sato Y, Sato Y, Sezai S, Ikeda Y Curr Ther Res Clin Exp. 2014; 67(1):1-20.

PMID: 24678081 PMC: 3965972. DOI: 10.1016/j.curtheres.2006.02.003.


Antioxidant properties of glutamine and its role in VEGF-Akt pathways in portal hypertension gastropathy.

Marques C, Licks F, Zattoni I, Borges B, de Souza L, Marroni C World J Gastroenterol. 2013; 19(28):4464-74.

PMID: 23901221 PMC: 3725370. DOI: 10.3748/wjg.v19.i28.4464.


Management of gastropathy and gastric vascular ectasia in portal hypertension.

Ripoll C, Garcia-Tsao G Clin Liver Dis. 2010; 14(2):281-95.

PMID: 20682235 PMC: 2916868. DOI: 10.1016/j.cld.2010.03.013.


References
1.
Hashizume M, Tanaka K, Inokuchi K . Morphology of gastric microcirculation in cirrhosis. Hepatology. 1983; 3(6):1008-12. DOI: 10.1002/hep.1840030619. View

2.
Spence R, Sloan J, JOHNSTON G, Greenfield A . Oesophageal mucosal changes in patients with varices. Gut. 1983; 24(11):1024-9. PMC: 1420105. DOI: 10.1136/gut.24.11.1024. View

3.
McCormack T, Sims J, Eyre-Brook I, Kennedy H, Goepel J, Johnson A . Gastric lesions in portal hypertension: inflammatory gastritis or congestive gastropathy?. Gut. 1985; 26(11):1226-32. PMC: 1432906. DOI: 10.1136/gut.26.11.1226. View

4.
VECCHIO T . Predictive value of a single diagnostic test in unselected populations. N Engl J Med. 1966; 274(21):1171-3. DOI: 10.1056/NEJM196605262742104. View

5.
McCray R, Martin F, Sheahan D, ZAMCHECK N . Erroneous diagnosis of hemorrhage from esophageal varices. Am J Dig Dis. 1969; 14(11):755-60. DOI: 10.1007/BF02235964. View