| Theme |
Diagnosis and Treatment of Portal Hypertention |
| Title |
Diagnosis and Treatment for Portal Hypertensive Gastropathy |
| Author |
Yasuhiro Nishizaki |
Digestive Disease and Hepatology Center, Tokai University Tokyo Hospital |
| Author |
Hirokazu Shiozawa |
Digestive Disease and Hepatology Center, Tokai University Tokyo Hospital |
| Author |
Fumitoshi Morino |
Digestive Disease and Hepatology Center, Tokai University Tokyo Hospital |
| Author |
Shigeyuki Motegi |
Digestive Disease and Hepatology Center, Tokai University Tokyo Hospital |
| Author |
Norihito Watanabe |
Department of Gastroenterology, School of Medicine, Tokai University |
| Author |
Tetsuya Mine |
Department of Gastroenterology, School of Medicine, Tokai University |
| [ Summary ] |
Portal hypertensive gastropathy (PHG) is a type of congestive mucosal lesion which is caused by increased portal vein pressure. Histologically, it is characterized by intramural edema, dilated capillaries and collecting venules, without inflammation. PHG is basically diagnosed under the endoscopy. The classification developed by McCormack, et al. in 1985 is widely used. Approximately 50 - 90 % of patients with portal hypertension are positive for PHG. However, H. pylori infection should be excluded. Acute bleeding is currently an indication for treatment. However, it is difficult to achieve proper treatment when systemic conditions are uncontrolled. The basis of correct treatment is providing a reduction in portal blood pressure, using β blockers and other measures. In recent years, the efficacy of argon plasma coagulation and angiotensin-II receptor antagonism has been reported. |