Portal hypertension gastropathy

After esophageal and fundus varices, portal hypertensive gastropathy (PHG) is the second most frequent cause of bleeding in cirrhotic patients, It accounts for 1-8% of primary upper gastrointestinal hemorrhage and 30-60% of secondary acute or chronic bleeding in the first 12 months, mainly after sclerosing therapy of varices, Endoscopy is diagnostic by showing either a typical ''mosaic pattern'' (mild form) or single or confluent ''cherry red spots'' (severe form). Helicobacter pylori or NSAID-induced gastropathy are to be distinguished. The therapeutic principles are the same as in drug therapy of esophageal varices. Secondary prophylaxis with propranolol, especially after sclerosing therapy, is recommended, but not primary prophylaxis.