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Portal hypertensive gastropathy refers to changes in the mucosa of the stomach in patients with portal hypertension; by far the most common cause of this is cirrhosis of the liver. These changes in the mucosa include friability of the mucosa and the presence of ectatic blood vessels at the surface.
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]
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]
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.
This results in portal hypertension. Effects of portal hypertension include: Ascites is a build-up of fluid in the peritoneal cavity in the abdomen [40] An enlarged spleen in 35–50% of cases [6] Esophageal varices and gastric varices result from collateral circulation in the esophagus and stomach (a process called portacaval anastomosis). [41]
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.
This includes mostly drug-induced hepatotoxicity, (DILI) which may generate many different patterns over liver disease, including . cholestasis; necrosis; acute hepatitis and chronic hepatitis of different forms,
Recent research has shown that autoimmune metaplastic atrophic gastritis (AMAG) is a result of the immune system attacking the parietal cells. [6]Environmental metaplastic atrophic gastritis (EMAG) is due to environmental factors, such as diet and H. pylori infection.