Review Portal hypertensive gastropathy and gastric antral vascular ectasia (GAVE) syndrome
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چکیده
Portal hypertensive gastropathy (PHG) and gastric antral vascular ectasia (GAVE) syndrome are recently characterised entities that can be associated with gastrointestinal blood loss in patients with and without cirrhosis. Up to 65% of patients with portal hypertension from cirrhosis will develop PHG but it can also occur in the setting of non-cirrhotic portal hypertension. In patients with portal hypertension, PHG is often associated with the presence of oesophageal and/or gastric varices. The mechanisms involved in the pathogenesis of PHG have not been fully elucidated. However, regulation of gastric nitric oxide, prostaglandins, tumour necrosis factor á (TNF-á), and epidermal growth factor (EGF) production may be involved. The mechanisms involved in the development of GAVE syndrome are also unclear. The classic features of this syndrome include red, often haemorrhagic, lesions predominantly located in the gastric antrum which can result in significant blood loss. More than 70% of patients with GAVE syndrome do not have cirrhosis or portal hypertension. However, in the setting of cirrhosis, GAVE syndrome can be diYcult to diVerentiate from PHG. This distinction is paramount in that PHG generally responds to a reduction in portal pressures whereas those with GAVE syndrome and coexisting portal hypertension generally do not respond to such therapy. This review will focus on the incidence, clinical importance, aetiology, pathophysiology, and treatment of PHG and GAVE syndrome, including diVerentiation between GAVE syndrome and PHG in the setting of portal hypertension.
منابع مشابه
Case report of gastric antral vascular ectasia (GAVE)
Gastric antral vascular ectasia (GAVE) is a rare clinical disease which can cause recurrent upper gastrointestinal (GI) tract bleeding. It is responsible for about 4% of non-variceal upper GI haemorrhages. As one of the vascular diseases that happened in stomach, GAVE was also named as watermelon stomach (WS) for its characteristic endoscopic performance. Compared with portal hypertensive gastr...
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Gastric antral vascular ectasia (GAVE), also known as "watermelon stomach", is an uncommon condition, which can cause gastrointestinal bleeding due to rupture of blood vessels that line the stomach. The pathogenesis of GAVE remains unclear; however it is thought that hemodynamic changes, mechanical stress, and autoimmune factors all have a part to play. A range of conditions are also commonly a...
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تاریخ انتشار 2001