Portal Hypertensive Gastropathy

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

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:

 A

Beta blocker

 B

TIPS

 C

Surgical portacaval shunt

 D

Liver transplantation

Q. 2

The best available treatment for portal hypertensive gastropathy is:

 A

Beta blocker

 B

TIPS

 C

Surgical portacaval shunt

 D

Liver transplantation

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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