Abstract
Gastric mucosal abnormalities resulting from portal hypertension are defined as "congestive gastropathy". A case of congestive gastropathy with unusual features, in a 63 year old man with a history of excessive alcohol intake and cirrhosis, is described. The patient underwent a subtotal gastrectomy because of profuse bleeding from a gastric ulcer, providing a large surgical specimen for examination. Unusual gross and histological findings included prominent arterial intimal hyperplasia, and diffuse duplication and focal fragmentation of the internal lamina elastica. The differential diagnosis of this condition includes primary angiodysplastic gastropathy such as Dieulafoy's disease. The similarity with Dieulafoy-like angiodysplasia emphasises that clear cut criteria to define gastric vascular lesions do not yet exist.
Full text
PDF
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Fowler D. L., Fortin D., Wood W. G., Pinkerton J. A., Jr, Koontz P. G., Jr Intestinal vascular malformations. Surgery. 1979 Sep;86(3):377–385. [PubMed] [Google Scholar]
- Leone O., Zanelli M., Santini D., Minni F., Marrano D. Dieulafoy's disease associated with early gastric cancer. J Clin Pathol. 1995 Mar;48(3):267–270. doi: 10.1136/jcp.48.3.267. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lewi H. J., Gledhill T., Gilmour H. M., Buist T. A. Arteriovenous malformations of the intestine. Surg Gynecol Obstet. 1979 Nov;149(5):712–716. [PubMed] [Google Scholar]
- Moore J. D., Thompson N. W., Appelman H. D., Foley D. Arteriovenous malformations of the gastrointestinal tract. Arch Surg. 1976 Apr;111(4):381–389. doi: 10.1001/archsurg.1976.01360220077013. [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]
- Triger D. R., Hosking S. W. The gastric mucosa in portal hypertension. J Hepatol. 1989 Mar;8(2):267–272. doi: 10.1016/0168-8278(89)90018-4. [DOI] [PubMed] [Google Scholar]