IMPROVEMENT OF PORTAL HYPERTENSIVE OASTROPATHY AFTER TRANSJUGULAR INTRAHEPATIC PGRTGSYSTEMIC SHUNT

Abstract

In order to clarify pathophysiology of gastric mucosal lesions observed in patients withportal hypertens20n called portal hypertensive gastropathy, (PHG), we compared thefindings of gastro-esophageal varices, gastric mucosal lesions and portal vein pressurebefore and after transjugular intrahepatic portosystemic shunt (TIPS) in nine patients withportal hypertension. Eight of those patients were admitted for variceai bleeding, and twoof them had a history of bleeding from PHA. Portal pressure (mmHg) was decreased from27.7 ± 7.6to 19.3 ± 5.1 imrnediately after TIPS. Endoscopic findings showed improvementof gastric mucosal lesions and gastro-esophageal varices in all nine patients after TIPS;especially in four of five patients with severe PHG, TIPS resulted in a marked improve-ment of PHA. These observations suggest that portal hypertension may contribute directlyto the development of PHA, and that TIPS which can reduce the portal pressure immedi-ately is a useful treatment far the bleeding from PHG.