Portal hypertensive gastropathy in cirrhotics without varices: a case-control study

Eur J Gastroenterol Hepatol. 2015 Jan;27(1):91-6. doi: 10.1097/MEG.0000000000000234.

Abstract

Objective: Information is lacking on portal hypertensive gastropathy (PHG) in cirrhotics without varices; our aim it is to evaluate whether clinical and sonographic parameters are associated with PHG and may provide information suitable for the management of these patients.

Patients and methods: After endoscopic selection of 145 cirrhotics without varices, 75 with PHG and 70 without PHG, clinical and sonographic characteristics were assessed.

Results: Forty portosystemic shunts were present in 27 patients. The mean Child-Pugh score was 6.3±1.4 and 5.6±0.5 in patients with severe and mild PHG, respectively (P=0.004). The mean portal vein diameter was 10.4±1.7 and 11.6±2.0 mm in cirrhotics without and with PHG, respectively (P=0.0002).

Conclusion: A link between the presence of PHG and a more advanced phase of cirrhosis was found. Duplex Doppler sonography was confirmed to be a valuable diagnostic method in monitoring cirrhosis. Management of these patients cannot be performed on the basis of a single diagnostic method, and a multimodal diagnostic approach is required.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blood Flow Velocity
  • Case-Control Studies
  • Endoscopy, Gastrointestinal
  • Female
  • Humans
  • Hypertension, Portal / complications
  • Hypertension, Portal / diagnostic imaging*
  • Hypertension, Portal / physiopathology
  • Liver Cirrhosis / complications*
  • Male
  • Middle Aged
  • Portal Vein / diagnostic imaging*
  • Predictive Value of Tests
  • Severity of Illness Index
  • Stomach Diseases / diagnosis*
  • Stomach Diseases / etiology
  • Ultrasonography, Doppler, Duplex