Tag: Portal hypertensive gastropathy

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.

Quiz In Between



Portal Hypertensive Gastropathy

Portal Hypertensive Gastropathy


PORTAL HYPERTENSIVE GASTROPATHY

  • Portal hypertensive gastropathy is due to increased portal pressure and collaterals, vascular dilation & ectasia occurs in stomach.
  • Usually affects proximal stomach.

 Clinical features-

  • Acute bledding
  • Anaemia
Classification-  

Investigations-

  • Endoscopically, appears pink speckled with red mosaic like pattern in the gastric mucosa.

Treatment-

  • Propanolol reduces bleeding
  • Pharmacological therapy aims at reducingportal venous pressure is used.
  • TIPSS is used if pharmacological therapy is failed.
  • Best treatment is liver transplantation.

Exam Important

  • Usually affects proximal stomach.
Classification-  

Investigations-

  • Endoscopically, appears pink speckled with red mosaic like pattern in the gastric mucosa.

Treatment- 

  • Best treatment is liver transplantation.
Don’t Forget to Solve all the previous Year Question asked on Portal Hypertensive Gastropathy

Module Below Start Quiz

Portal hypertensive gastropathy

Portal hypertensive gastropathy


Portal hypertensive gastropathy

  • Usually affects proximal stomach
  • Unlike variceal hemorrhage, bleeding from portal hypertensive gastropathy is not amenable to endoscopic treatment because of the diffuse nature of the mucosal abnormalities.
  • The underlying pathology involves elevated portal venous pressures, so pharmacologic therapy aimed at reducing portal venous pressure is indicated.
  • If pharmacologic therapy fails to control acute bleeding, TIPS should be considered

Exam Question

  • 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

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.

Don’t Forget to Solve all the previous Year Question asked on Portal hypertensive gastropathy

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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