McCormack et al described the endoscopic and microscopic changes seen in patients with portal hypertensive gastropathy. The authors are from Sheffield University and the Royal Hallamshire Hospital in Sheffield, England.


Endoscopic findings:

(1) findings seen in mild gastritis, as described by Taor et al

(2) findings seen in more severe disease


Endoscopic findings in mild to moderate gastritis:

(1) fine pink speckling, or "scarlatina" type rash

(2) superficial reddening, which gives the superficial rugae a striped appearance

(3) a fine white reticular pattern separating areas of raised red edematous mucosa resembling a "snake skin"



• The reticular pattern is analogous to the mosaic patterns described by Tanoue et al and others.


Endoscopic findings in more severe gastropathy:

(1) discrete red spots similar to the cherry red spots seen in esophagus, which can become confluent and which may bleed

(2) diffuse hemorrhagic gastritis


Histopathologic features in endoscopic biopsies:

(1) normal

(2) gastritis

(3) mucosal and/or submucosal vascular ectasia involving capillaries and veins


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