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Most patients with portal hypertensive gastropathy have either a stable or improving course in the appearance of the gastropathy on endoscopy.However, according to retrospective data, roughly one in seven patients with portal hypertensive gastropathy will develop bleeding (either acute or chronic) attributable to the gastropathy. [1]
The endoscopic appearance of GAVE is similar to portal hypertensive gastropathy, but is not the same condition, and may be concurrent with cirrhosis of the liver. [2] [6] [15] [16] 30% of all patients have cirrhosis associated with GAVE. [6] Sjögren's syndrome has been associated with at least one patient. [17]
Gastric varices are dilated submucosal veins in the lining of the stomach, which can be a life-threatening cause of bleeding in the upper gastrointestinal tract.They are most commonly found in patients with portal hypertension, or elevated pressure in the portal vein system, which may be a complication of cirrhosis.
The term gastropathy means "stomach disease" and is included in the name of the diseases portal hypertensive gastropathy, hyperplastic hypersecretory gastropathy (Ménétrier's disease), and others. However, not all stomach diseases are labeled with the word "gastropathy"; examples include peptic ulcer disease, gastroparesis, and dyspepsia.
In cases of refractory bleeding, balloon tamponade with a Sengstaken–Blakemore tube may be necessary, or the use of a fully-covered esophageal self-expandable metallic stent, usually as a bridge to further endoscopy or treatment of the underlying cause of bleeding (i.e.: portal hypertension).
A dilated portal vein (diameter of greater than 13 or 15 mm) is a sign of portal hypertension, with a sensitivity estimated at 12.5% or 40%. [18] On Doppler ultrasonography , a slow velocity of <16 cm/s in addition to dilatation in the main portal vein are diagnostic of portal hypertension. [ 19 ]
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Therapeutic endoscopy is the medical term for an endoscopic procedure during which treatment is carried out via the endoscope. This contrasts with diagnostic endoscopy , where the aim of the procedure is purely to visualize a part of the gastrointestinal , respiratory or urinary tract in order to aid diagnosis .