The management of portal hypertensive gastropathy and gastric antral vascular ectasia

被引:49
作者
Ripoll, Cristina [3 ,4 ]
Garcia-Tsao, Guadalupe [1 ,2 ]
机构
[1] Yale Univ, Sch Med, Digest Dis Sect, New Haven, CT 06510 USA
[2] VA CT Healthcare Syst, New Haven, CT USA
[3] Hosp Gen Gregorio Maranon, Serv Aparato Digest, Madrid, Spain
[4] CIBERehd, Barcelona, Spain
关键词
Chronic anaemia; Cirrhosis; Gastrointestinal bleeding; Gastropathy; Vascular ectasia; ARGON PLASMA COAGULATION; INTRAHEPATIC PORTOSYSTEMIC SHUNT; WATERMELON STOMACH; CIRRHOTIC-PATIENTS; NATURAL-HISTORY; CAPSULE ENDOSCOPY; VARICEAL HEMORRHAGE; ESOPHAGEAL-VARICES; PRESSURE-GRADIENT; GI TRACT;
D O I
10.1016/j.dld.2010.10.006
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Portal hypertensive gastropathy and gastric antral vascular ectasia are gastric mucosal lesions that can cause chronic gastrointestinal haemorrhage and, consequently, chronic anaemia, in patients with cirrhosis. Although chronic anaemia is the most common clinical manifestation, these entities may also lead to acute gastrointestinal bleeding. Despite similar clinical manifestations, their pathophysiology and management are entirely different. Their diagnosis is endoscopic and although generally each of them has a characteristic endoscopic appearance and distribution, there are cases in which the differential is difficult and must rely on histology. This review focuses on the management of both entities. The mainstay of management of portal hypertensive gastropathy is based on portal-hypotensive pharmacological treatment whilst gastric antral vascular ectasia benefits from endoscopic therapy. More invasive options should be reserved for refractory cases. Published by Elsevier Ltd on behalf of Editrice Gastroenterologica Italiana S.r.l.
引用
收藏
页码:345 / 351
页数:7
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