You have forgotten your username or password, we can .My Menu Saved Items дёж–‡(з®ЂдЅ") дёж–‡(з№Ѓй«") English Deutsch н•њкµм–ґ ж—Ґжњ¬иЄћ Franais Espaol Ш§Щ„Ш№Ш±ШЁЩЉШ© Р СѓСЃСЃРєРёР№ Journal Article TREATMENT OF GASTROPATHY AND GASTRIC ANTRAL VASCULAR ECTASIA IN PATIENTS WITH PORTAL HYPERTENSION Journal Publisher Current Medicine Group LLC ISSN 1092-8472 (Print) 1534-309X (Online) Issue DOI 10.483-494 Subject Collection SpringerLink Date Saturday, March 15, 2008 Treatment of gastropathy and gastric antral vascular ectasia in patients with portal hypertension Cristina Ripoll and Guadalupe Garcia-Tsao1 (1) Digestive Diseases Section, Yale University School of Medicine, 333 Cedar Street-1080 LMP, New Haven, CT 06510, USA PUBLISHED ONLINE: 15 March 2008 Opinion statement Portal hypertensive gastropathy (PHG) and gastric antral vascular ectasia (GAVE) are two distinct gastric mucosal lesions that may cause acute and/or chronic upper gastrointestinal hemorrhage in patients with cirrhosis.Is associated with portal hypertension, GAVE may present in patients without portal hypertension or liver disease.Made upon visualization of the characteristic lesions with upper gastrointestinal endoscopy, although the differential may be difficult at times.Is characterized endoscopically by a mosaic pattern with or without red signs and a proximal distribution.Mainly causes chronic blood loss and anemia in patients with cirrhosis but also can cause acute hemorrhage.Therapy for chronic hemorrhage from PHG is a nonselective -blocker (propranolol or nadolol) and iron supplementation.Bleeding/anemia are not controlled with these measures and the patient is transfusion-dependent, shunt therapy (transjugular intrahepatic portosystemic shunt or shunt surgery) should be considered.Acute bleeding from PHG, an infrequent event, should be aplished with a vasoactive drug, somatostatin (or its analogues) or terlipressin.Bleeding responds, the patient must be switched to a nonselective -blocker.Therapy should be considered in patients who rebleed or continue to bleed despite adequate -blocker therapy.Lessmon than PHG.Is characterized by red spots without a background mosaic pattern, typically in the gastric antrum.Have a linear distribution, the lesion is called "watermelon stomach.Is a cause of chronic gastrointestinal bleeding and anemia in patients with cirrhosis.Lesions are localized, first-line therapy is argon plasma coagulation.More diffuse lesions, therapy with argon plasma coagulation is moreplicated.Suggest that cryotherapy may be a reasonable option for diffuse GAVE lesions.-blockers nor TIPS reduces the bleeding risk in patients with GAVE and thus should not be used in this setting.GARCIA-TSAO EMAIL: References secured to subscribers.Find Query Builder Close Clear Within all content Within this journal Within this issue Export this article Export this article as RIS Text В© Springer.Read more Lovenox(enoxaparin sodium) solution [sanofi-aventis u.s. llc]
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