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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.
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]
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.
The term gastropathy means "stomach disease" and is included in the name of the diseases portal hypertensive gastropathy, hyperplastic hypersecretory gastropathy (Ménétrier's disease), and others. However, not all stomach diseases are labeled with the word "gastropathy"; examples include peptic ulcer disease, gastroparesis, and dyspepsia.
Reactive gastropathy is morphologically distinct entity [3] [4] that can be separated from gastritis, which by definition has a significant inflammatory component. As a reactive gastropathy may mimic a (true) gastritis symptomatically and visually in an endoscopic examination , it may incorrectly be referred to as a gastritis.
This peri-cellular chickenwire fibrosis leads to portal hypertension or an elevated blood pressure in the portal veins that drain blood from the intestines to the liver. [7] This causes many of the sequelae of chronic liver disease including esophageal varices (with associated variceal bleeding), ascites and splenomegaly.
Steatohepatitis is a type of fatty liver disease, characterized by inflammation of the liver with concurrent fat accumulation in liver. Mere deposition of fat in the liver is termed steatosis, and together these constitute fatty liver changes.