Tyagi Pankaj, Puri Amarender S, Sharma Brijesh C, Sachdeva Sanjeev, Saran Ravinder K, Bhatia Vikram
Departmnent of Gastroenterology, G B Pant Hospital, New Delhi 110 002, India.
Indian J Gastroenterol. 2012 Apr;31(2):75-8. doi: 10.1007/s12664-012-0164-6. Epub 2012 Feb 29.
Portal hypertension is known to cause esophageal varices, gastric varices and portal hypertensive gastropathy (PHG). The prevalence of gastric varices and PHG is known to increase after eradication of esophageal varices. PHG includes the presence of a mucosal mosaic pattern, cherry red spots, and/or black-brown spots and gastric vascular ectasia (GAVE). Patients with portal hypertension in whom esophageal varices were eradicated were on follow up endoscopy for detection of recurrence of esophageal varices. Their status of PHG was assessed and patients antral nodules were enrolled. Twenty patients with antral nodules were identified over one year. Fifteen out of 20 patients had cirrhosis as etiology of portal hypertension, three had non-cirrhotic portal hypertension and two had extra-hepatic portal vein thrombosis. GAVE was seen more commonly (n=8, 40%) in patients with PHG with nodules. PHG with antral nodules is a novel endoscopic finding present both in cirrhotic and non-cirrhotic portal hypertension with unknown pathogenesis, and is seen more commonly in patients with eradicated varices who are on long-term follow up.
门静脉高压症已知可导致食管静脉曲张、胃静脉曲张和门静脉高压性胃病（PHG）。已知食管静脉曲张根除后胃静脉曲张和PHG的患病率会增加。PHG包括黏膜马赛克样改变、樱桃红点和/或黑褐色斑点以及胃血管扩张（GAVE）。对已根除食管静脉曲张的门静脉高压症患者进行内镜随访，以检测食管静脉曲张复发情况。评估他们的PHG状态，并纳入有胃窦结节的患者。一年多来共识别出20例有胃窦结节的患者。20例患者中有15例的门静脉高压病因是肝硬化，3例是非肝硬化门静脉高压，2例是肝外门静脉血栓形成。GAVE在有结节的PHG患者中更常见（n = 8，40%）。伴有胃窦结节的PHG是一种新的内镜表现，在肝硬化和非肝硬化门静脉高压中均有出现，发病机制不明，且在长期随访的已根除静脉曲张患者中更常见。
