Portal Hypertensive Gastropathy

Q. 1

All are classification systems of portal hypertensive gastropathy, EXCEPT:

A		McCormack
B		Tanoue
C		Los angeles
D		NIEC = New Italian Endoscopic Club

Ans. C

Explanation:

Classification of Portal Hypertensive Gastropathy

McCormack	Tanoue	NIEC = New Italian Endoscopic Club.
Mild	Grade I	Mosaic pattern
Fine pink speckling (scarlatina-type rash)	Mild reddening	Mild: diffuse pink areola
Superficial reddening	Congestive mucosa	Moderate: flat red spot in the pink areola
Mosaic pattern		Severe: diffuse red areola
Severe	Grade II	Red mark lesion
Discrete red spots	Severe redness and a fine reticular pattern separating the areas of raised edematous mucosa	Discrete
Diffuse hemorrhagic lesion		Confluent (diffuse)
	Grade III	Black brown spot
	Point bleeding + grade II

NIEC = New Italian Endoscopic Club.

Ref: GASTROINTESTINAL ENDOSCOPY Volume 66, No. 2 : 2007

Q. 2 The best available treatment for portal hypertensive gastropathy is:

Ans. D

Explanation:

Portal hypertensive gastropathy (PHG) is the ectatic blood vessels in the proximal gastric body and cardia causing oozing of the blood.

Less severe grades of PHG appear as a mosaic or snakeskin pattern and are not associated with bleeding.

Severe PHG with diffuse bleeding is treated by β-adrenergic receptor blockers or possibly with placement of a TIPS or surgical portacaval shunt.

The best treatment is liver transplantation

Ref:Sleisenger and Fordtran’s,E-9,P-300.

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