Portal Hypertensive Gastropathy (PHG)

Reversal of erosive gastritis in patients with portal hypertension by surgical shunts evolves the term of portal hypertensive gastropathy. In 1984, Sarfeh et al. addressed the term PHG to describe the distinctive erosive gastritis in patients with portal hypertension. Since that time, the recorded incidence of PHG in the studies has varied widely from 20 to 75% in patients with portal hypertension, with or without liver cirrhosis. As the underlying pathophysiology of the disease is unclear, not all the patients with portal hypertension developed PHG. Thus, portal hypertension cannot be the only factor for the development of PHG. Patients with PHG presented with either acute or chronic bleedings. Acute presentation is an emergency case. Anemia from chronic bleeding is a frequent presentation in PHG patients. The diagnosis is confirmed by a characteristic endoscopic appearance of PHG. Capsule endoscopy and dynamic CT are also used for the diagnosis of PHG. The goal of the treatment of PHG is reducing the portal pressure in patients with acute or chronic bleeding. Pharmacological treatment, endoscopic therapy, trans‐jugular intrahepatic portosystemic shunt (TIPS), and shunt surgery are different modalities for treatment of PHG. Yet, primary prophylaxis treatment is not recommended in the patients with PHG.