[Gastrointestinal haemorrhage related to portal hypertension. The pathologist's viewpoint (author's transl)].

Study of as homogeneous series as possible of 72 cases of gastrointestinal haemorrhage in patients with portal hypertension showed that the major cause of bleeding, accounting for almost 70% of cases, was ulceration of oesophageal varices. The presence at autopsy of haemorrhagic or necrotic lesions of the gastric mucosa is not felt to be a definite argument in favour of a gastric origin of the bleeding. Ulceration of gastric varices is considered to be an uncommon possibility, by virtue of the absence of dystrophic changes in the overlying mucosa, in contrast to the state of affairs seen in the oesophagus. Finally, the authors noted the relatively common presence of an associated malignant tumour (more than 8% of cases). This should perhaps lead to more profound investigations in order to seek a malignant intra- or extrahepatic malignant tumour before any bypass procedure to correct portal hypertension is undertaken.