Portal hypertensive gastropathy / enteropathy / colopathy
In portal hypertension, chronic portal venous congestion leads to dilatation and ectasia of the submucosal vessels in 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 an iron-deficiency anemia.
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.
- 1. Chang D et al, Portal hypertensive gastropathy: radiographic findings in eight patients, American Journal of Radiology 2000; 175:1609-1612
- 2. Kaufman J & Lee M, Vascular & Interventional Radiology The Requisites, Mosby 2004