The Natural History of Portal Hypertensive Gastropathy: Influence of Variceal Eradication

Sarin, Shiv Kumar; Shahi, Hansa M; Jain, Monika; Jain, Ajay K.; Issar, Sanjeev Kumar; Murthy, Nandgudi S

doi:10.1111/j.1572-0241.2000.03200.x

Cited by 108 publications

(49 citation statements)

References 20 publications

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“…Such a progression of varices in NCPF is less likely to occur, as the liver function continues to be normal. Similarly, a decrease in the size of esophageal varices, as seen in patients with cirrhosis with an improvement in liver functions is unlikely in NCPF, unless interventions like endoscopic sclerotherapy are applied, which after variceal obliteration results in the development of spontaneous splenorenal shunts [111][112][113][114]. Endoscopic variceal ligation (EVL) and beta blockers are the common modes of therapy for the primary prophylaxis of large esophageal varices in cirrhosis [115].…”

Section: Combined Pharmacological and Endoscopic Therapymentioning

confidence: 99%

Noncirrhotic portal fibrosis/idiopathic portal hypertension: APASL recommendations for diagnosis and treatment

et al. 2007

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The Asian Pacific Association for the Study of the Liver (APASL) Working Party on Portal Hypertension has developed consensus guidelines on the disease profile, diagnosis, and management of noncirrhotic portal fibrosis and idiopathic portal hypertension. The consensus statements, prepared and deliberated at length by the experts in this field, were presented at the annual meeting of the APASL at Kyoto in March 2007. This article includes the statements approved by the APASL along with brief backgrounds of various aspects of the disease.

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Section: Combined Pharmacological and Endoscopic Therapymentioning

confidence: 99%

Noncirrhotic portal fibrosis/idiopathic portal hypertension: APASL recommendations for diagnosis and treatment

et al. 2007

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“…31 Portal hypertensive gastropathy is uncommon in NCPF patients and is a rare cause of upper gastrointestinal bleeding at the initial presentation. 49 Gastropathy, however, develops after endoscopic sclerotherapy or variceal ligation in a fair proportion of patients. Post-variceal obliteration gastropathy is often transitory or nonprogressive in NCPF patients ( Table 6).…”

Section: Endoscopymentioning

confidence: 99%

Non‐cirrhotic portal fibrosis: Current concepts and management

Sarin

Kapoor

2002

J of Gastro and Hepatol

150

183

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Non-cirrhotic portal hypertension (NCPH) comprises diseases having an increase in portal pressure (PP) due to intraheptic or prehepatic lesions, in the absence of cirrhosis. The lesions are generally vascular, either in the portal vein, its branches or in the perisinusoidal area. Because the wedged hepatic venous pressure is near normal, measurement of intravariceal or intrasplenic pressure is needed to assess PP. The majority of diseases included in the category of NCPH are well-characterized disease entities where portal hypertension (PHT) is a late manifestation and, hence, these are not discussed. Two diseases that present only with features of PHT and are common in developing countries are non-cirrhotic portal fibrosis (NCPF) and extrahepatic portal vein obstruction (EHPVO). Non-cirrhotic portal fibrosis is a syndrome of obscure etiology, characterized by 'obliterative portovenopathy' leading to PHT, massive splenomegaly and well-tolerated episodes of variceal bleeding in young adults from low socioeconomic backgrounds, having near normal hepatic functions. In some parts of the world, NCPF is called idiopathic portal hypertension (IPH) or 'hepatoportal sclerosis'. Because 85-95% of patients with NCPF and EHPVO present with variceal bleeding, treatment involves management with endoscopic sclerotherapy (EST) or variceal ligation (EVL). These therapies are effective in approximately 90-95% of patients. Gastric varices are another common cause of upper gastrointestinal bleeding in these patients and these can be managed with cyanoacrylate glue injection or surgery. Other indications for surgery include failure of EST/EVL, and symptomatic hypersplenism. The prognosis of patients with NCPF is good and 5 years survival in patients in whom variceal bleeding can be controlled has been reported to be approximately 95-100%.

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“…Other sources of bleeding in PHT might include portal hypertensive gastropathy [15], gastric [16], duodenal [17] and ano-rectal varices [18]. Variceal bleeding in children is often triggered by an episode of upper respiratory tract infection, fever or aspirin ingestion [19]. Initial management includes stabilisation with considered fluid and blood product resuscitation and pharmacological therapy with agents such as octreotide or vasopressin.…”

Section: Discussionmentioning

confidence: 98%

Surviving Sengstaken

Jayakumar¹,

Odulaja²,

Patel³

et al. 2015

Journal of Pediatric Surgery

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The Natural History of Portal Hypertensive Gastropathy: Influence of Variceal Eradication

Abstract: PHG developing after variceal eradication is often transitory and less severe. If PHG is pre-existing, endoscopic therapy for varices could worsen the PHG, with a likelihood of bleeding. Such patients may be benefited by concomitant beta-blocker therapy.

Cited by 108 publications

References 20 publications

Noncirrhotic portal fibrosis/idiopathic portal hypertension: APASL recommendations for diagnosis and treatment

Noncirrhotic portal fibrosis/idiopathic portal hypertension: APASL recommendations for diagnosis and treatment

Non‐cirrhotic portal fibrosis: Current concepts and management

Surviving Sengstaken

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