Cirrhosis Associated Congestive Gastropathy
Cirrhosis associated congestive gastropathy (CG) is an endoscopic and histological condition located in gastric mucosa, characterized mainly by vascular alterations. While the endoscopic picture, although well classified by Mc Kormack description, is not specific, the histological findings are typical, and comprehend initially inflammatory lesions, and in more advanced stages microvascular lesions. The supposed pathogenesis of such alterations is a deregulated release of vasoactive substances, with prevalence of vasodilators. The main factor implicated seems to be nytric oxyde (NO), overproducted by inducible NO-syntase, related to endotoxemia. In this study we have tried to better define the prevalence of vascular and inflammatory lesions in CG and to relate them to the pathogenetic process. We have considered the endoscopic and histologic observations in a cirrhotic population, grading each parameter in an attempt to find significant association. The results obtained show that both inflammatory and vascular lesions are present in about 80% of cases, and that also in 78% of patients there was a bacterial pollution that is significantly related to esophageal varices, vascular and inflammatory histological damage but not to endoscopic evidence of GC. We conclude that the possible pathogenic mechanism may start from blood stasis with vasodilatation, followed by bacterial pollution which causes mucosal damage and an inflammatory reaction.
KeywordsGastric Mucosa Portal Hypertension Cirrhotic Patient Atrial Natriuretic Peptide Esophageal Varix
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