Abstract
Congestive gastropathy is a frequent cause of upper gastrointestinal haemorrhage in patients with portal hypertension. The pathogenesis is thought to involve venous congestion with gastric mucosal capillary dilatation. We studied the relation between gastric mucosal capillary dilatation, measured morphometrically, and endoscopic appearances in 74 patients with portal hypertension and 20 control subjects. We also investigated the frequency of gastric colonisation with Helicobacter pylori. Mucosal capillaries in patients were significantly dilated compared with control subjects (p less than 0.001) but the degree of dilatation was not related to the severity of the endoscopic appearances. H pylori was identified in 19 of 74 (26%) patients but was not related to the severity of the endoscopic appearances. These results suggest that other factors in addition to mucosal venous and capillary congestion are important in the pathogenesis of endoscopic congestive gastropathy and that gastric colonisation with H pylori is unlikely to be one of these factors.
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- Corbishley C. M., Saverymuttu S. H., Maxwell J. D. Use of endoscopic biopsy for diagnosing congestive gastropathy. J Clin Pathol. 1988 Nov;41(11):1187–1190. doi: 10.1136/jcp.41.11.1187. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Foster P. N., Wyatt J. I., Bullimore D. W., Losowsky M. S. Gastric mucosa in patients with portal hypertension: prevalence of capillary dilatation and Campylobacter pylori. J Clin Pathol. 1989 Sep;42(9):919–921. doi: 10.1136/jcp.42.9.919. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Groszmann R. J., Colombato L. A. Gastric vascular changes in portal hypertension. Hepatology. 1988 Nov-Dec;8(6):1708–1710. doi: 10.1002/hep.1840080639. [DOI] [PubMed] [Google Scholar]
- Hashizume M., Tanaka K., Inokuchi K. Morphology of gastric microcirculation in cirrhosis. Hepatology. 1983 Nov-Dec;3(6):1008–1012. doi: 10.1002/hep.1840030619. [DOI] [PubMed] [Google Scholar]
- Hosking S. W., Kennedy H. J., Seddon I., Triger D. R. The role of propranolol in congestive gastropathy of portal hypertension. Hepatology. 1987 May-Jun;7(3):437–441. doi: 10.1002/hep.1840070304. [DOI] [PubMed] [Google Scholar]
- McCormack T. T., Sims J., Eyre-Brook I., Kennedy H., Goepel J., Johnson A. G., Triger D. R. Gastric lesions in portal hypertension: inflammatory gastritis or congestive gastropathy? Gut. 1985 Nov;26(11):1226–1232. doi: 10.1136/gut.26.11.1226. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Papazian A., Braillon A., Dupas J. L., Sevenet F., Capron J. P. Portal hypertensive gastric mucosa: an endoscopic study. Gut. 1986 Oct;27(10):1199–1203. doi: 10.1136/gut.27.10.1199. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pugh R. N., Murray-Lyon I. M., Dawson J. L., Pietroni M. C., Williams R. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg. 1973 Aug;60(8):646–649. doi: 10.1002/bjs.1800600817. [DOI] [PubMed] [Google Scholar]
- Quintero E., Pique J. M., Bombi J. A., Bordas J. M., Sentis J., Elena M., Bosch J., Rodes J. Gastric mucosal vascular ectasias causing bleeding in cirrhosis. A distinct entity associated with hypergastrinemia and low serum levels of pepsinogen I. Gastroenterology. 1987 Nov;93(5):1054–1061. doi: 10.1016/0016-5085(87)90569-5. [DOI] [PubMed] [Google Scholar]
- Sarfeh I. J., Juler G. L., Stemmer E. A., Mason G. R. Results of surgical management of hemorrhagic gastritis in patients with gastroesophageal varices. Surg Gynecol Obstet. 1982 Aug;155(2):167–170. [PubMed] [Google Scholar]
- Sarfeh I. J., Soliman H., Waxman K., Coccia M., Rypins E. B., Bui H. X., Tarnawski A. Impaired oxygenation of gastric mucosa in portal hypertension. The basis for increased susceptibility to injury. Dig Dis Sci. 1989 Feb;34(2):225–228. doi: 10.1007/BF01536055. [DOI] [PubMed] [Google Scholar]
- Schnell G. A., Schubert T. T. Usefulness of culture, histology, and urease testing in the detection of Campylobacter pylori. Am J Gastroenterol. 1989 Feb;84(2):133–137. [PubMed] [Google Scholar]
- Whitehead R., Truelove S. C., Gear M. W. The histological diagnosis of chronic gastritis in fibreoptic gastroscope biopsy specimens. J Clin Pathol. 1972 Jan;25(1):1–11. doi: 10.1136/jcp.25.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]