Gastric Antral Vascular Ectasia and Portal Hypertensive Gastropathy

Abstract

Gastric antral vascular ectasia (GAVE) and portal hypertensive gastropathy (PHG) are mucosal lesions that can cause chronic gastrointestinal bleeding in the patients with cirrhosis. While PHG occurs exclusively in patients with liver cirrhosis, GAVE can also present in patients with systemic and autoimmune conditions. The need to accurately characterize these two conditions is dependent on clinical, endoscopic, and histological parameters. The management of GAVE utilizes endoscopic ablation techniques, while medical therapy is directed toward stabilizing portal pressure in patients with PHG. Herein, we review the epidemiology, diagnosis, pathophysiology, and medical, endoscopic, and surgical management of GAVE and PHG.

Gastric Microvasculature in Portal Hypertension

“…A condition that may simulate PHG closely is from GAVE (Gastric Antral Vascular Ectasia) and differentiating between the two conditions is important because they have distinct pathologic, clinical and endoscopic features, and different therapeutic measures [45,49]. GAVE may be frequently seen in association with primary liver, cardiac or kidney diseases.…”

“…And vascular ectasia to be the result of stasis and mechanical obstruction to blood flow in the affected site. In order to prove such hypothesis to be the cause for the development of GAVE, it will also be necessary to document mucosal fold size and status of the lumen of the pyloric channel and sphincter [47][48][49][50].…”