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Patients with portal hypertensive gastropathy may experience bleeding from the stomach, which may uncommonly manifest itself in vomiting blood or melena; however, portal hypertension may cause several other more common sources of upper gastrointestinal bleeding, such as esophageal varices and gastric varices. On endoscopic evaluation of the ...
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.
Portal hypertension is defined as increased portal venous pressure, with a hepatic venous pressure gradient greater than 5 mmHg. [3] [4] Normal portal pressure is 1–4 mmHg; clinically insignificant portal hypertension is present at portal pressures 5–9 mmHg; clinically significant portal hypertension is present at portal pressures greater than 10 mmHg. [5]
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]
Axial CT showing esophageal varices in liver cirrhosis with portal hypertension. Dilated submucosal veins are the most prominent histologic feature of esophageal varices. The expansion of the submucosa leads to elevation of the mucosa above the surrounding tissue, which is apparent during endoscopy and is a key diagnostic feature.
Medications typically includes octreotide or if not available vasopressin and nitroglycerin to reduce portal pressures. [21] This is typically in addition to endoscopic banding or sclerotherapy for the varices. [21] If this is sufficient then beta blockers and nitrates may be used for the prevention of re-bleeding. [21]
Police in Laos have detained the manager and seven staff members of a backpacker hostel in Vang Vieng following the deaths of six tourists from suspected methanol poisoning, state media reported ...
Portal venous pressure is the blood pressure in the hepatic portal vein, and is normally between 5-10 mmHg. [1] Raised portal venous pressure is termed portal hypertension , [ 2 ] and has numerous sequelae such as ascites and hepatic encephalopathy .