Portal hypertensive gastroenterocolopathy

Last revised by Henry Knipe on 23 Jan 2024

Portal hypertensive gastroenterocolopathy is a finding in portal hypertension, whereby chronic portal venous congestion leads to dilatation and ectasia of the submucosal vessels of the stomach (portal hypertensive gastropathy), small bowel (portal hypertensive enteropathy) and/or large bowel (portal hypertensive colopathy). This may result in upper or lower gastrointestinal (GI) bleeding, even in the absence of varices. The bleeding may be acute or chronic but is most commonly chronic low-grade GI blood loss associated with iron-deficiency anemia. 


Colonic wall abnormalities may be seen in around 35-40% of the patients with cirrhosis.

  • 25% of patients tend to have isolated or predominantly right-sided colonic changes 4

Radiographic features


Barium studies may show thickening of the mucosal folds and nodular filling defects. 


On CT there may be bowel wall thickening and hyperemia, which can mimic enterocolitis.

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