Persistent hemorrhagic gastritis in a patient with portal hypertension and esophagogastric varices: the role of portal decompressive surgery.

Our patient, with cirrhosis, portal hypertension, varices, and chronic gastrointestinal bleeding from hemorrhagic gastritis, illustrates an important therapeutic principle. Since the gastritis is related to vascular changes and congestion of the stomach wall secondary to increased portal pressure, and not inflammation, measures aimed at local healing or surgical removal of the bleeding area fail. One must attempt to lower portal pressure with drugs such as propranolol and/or undertake portal decompressive surgery.