Portal hypertensive vasculopathy – An entity worth remembering with non-neoplastic gastrointestinal lesions

Portal hypertensive vasculopathy (PHV) represents an increase in the pressure in the portal circulation. This increased pressure leads to changes in the mucosa that can be appreciated endoscopically as well as histopathologically. Lesions can be observed in the entire gastrointestinal tract (GIT) in...

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Autores principales:	Vatsala Misra, Ranjan Agrawal, Sri Praksh Misra
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer Medknow Publications 2021
Materias:	colopathy enteropathy gastropathy mucosa portal hypertension vasculopathy. Pathology RB1-214 Microbiology QR1-502
Acceso en línea:	https://doaj.org/article/0561664bd06a464d912e427aff455177
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spelling	oai:doaj.org-article:0561664bd06a464d912e427aff4551772021-12-02T19:23:04ZPortal hypertensive vasculopathy – An entity worth remembering with non-neoplastic gastrointestinal lesions0377-492910.4103/ijpm.ijpm_201_21https://doaj.org/article/0561664bd06a464d912e427aff4551772021-01-01T00:00:00Zhttp://www.ijpmonline.org/article.asp?issn=0377-4929;year=2021;volume=64;issue=5;spage=32;epage=42;aulast=Misrahttps://doaj.org/toc/0377-4929Portal hypertensive vasculopathy (PHV) represents an increase in the pressure in the portal circulation. This increased pressure leads to changes in the mucosa that can be appreciated endoscopically as well as histopathologically. Lesions can be observed in the entire gastrointestinal tract (GIT) including stomach, duodenum, jejunum and colon. The histological changes are appreciated mainly in the mucosal and submucosal blood vessels. A knowledge of these lesions as well as the changes helps in separating them from other close differentials with specific treatment to be instituted. The pathogenesis of the hemodynamic changes is not well-understood. The underlying factor is increased portal pressure. Studies indicate, that besides increased portal pressure other factors in combination led to the observed changes. Portal hypertensive gastropathy (PHG) is seen in the gastric body and fundus, while varices are noted in the cardia and fundus. Changes may be seen in the small intestine and throughout the colon with anorectal varices. Histopathological changes include dilated, congested and ectatic capillaries and edema in the lamina propria besides a large spectrum of other histopathological changes. Mucosal capillaries with thick irregular wall show absence of red blood cells in the lumen. Thickening of the vessel wall serves as a better marker than the vascular diameter when portal hypertension (PHT) is considered. Long standing cases may show fibrosis in lamina propria. At times, these changes may lead to occult gastrointestinal bleeding. Important differentials need to be ruled out in all the cases as the treatment and the outcome of all differs. Endoscopically or histopathologically if the mucosal changes are observed they should not be overlooked and a detailed work-up must be carried out.Vatsala MisraRanjan AgrawalSri Praksh MisraWolters Kluwer Medknow Publicationsarticlecolopathyenteropathygastropathymucosaportal hypertensionvasculopathy.PathologyRB1-214MicrobiologyQR1-502ENIndian Journal of Pathology and Microbiology, Vol 64, Iss 5, Pp 32-42 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	colopathy enteropathy gastropathy mucosa portal hypertension vasculopathy. Pathology RB1-214 Microbiology QR1-502
spellingShingle	colopathy enteropathy gastropathy mucosa portal hypertension vasculopathy. Pathology RB1-214 Microbiology QR1-502 Vatsala Misra Ranjan Agrawal Sri Praksh Misra Portal hypertensive vasculopathy – An entity worth remembering with non-neoplastic gastrointestinal lesions
description	Portal hypertensive vasculopathy (PHV) represents an increase in the pressure in the portal circulation. This increased pressure leads to changes in the mucosa that can be appreciated endoscopically as well as histopathologically. Lesions can be observed in the entire gastrointestinal tract (GIT) including stomach, duodenum, jejunum and colon. The histological changes are appreciated mainly in the mucosal and submucosal blood vessels. A knowledge of these lesions as well as the changes helps in separating them from other close differentials with specific treatment to be instituted. The pathogenesis of the hemodynamic changes is not well-understood. The underlying factor is increased portal pressure. Studies indicate, that besides increased portal pressure other factors in combination led to the observed changes. Portal hypertensive gastropathy (PHG) is seen in the gastric body and fundus, while varices are noted in the cardia and fundus. Changes may be seen in the small intestine and throughout the colon with anorectal varices. Histopathological changes include dilated, congested and ectatic capillaries and edema in the lamina propria besides a large spectrum of other histopathological changes. Mucosal capillaries with thick irregular wall show absence of red blood cells in the lumen. Thickening of the vessel wall serves as a better marker than the vascular diameter when portal hypertension (PHT) is considered. Long standing cases may show fibrosis in lamina propria. At times, these changes may lead to occult gastrointestinal bleeding. Important differentials need to be ruled out in all the cases as the treatment and the outcome of all differs. Endoscopically or histopathologically if the mucosal changes are observed they should not be overlooked and a detailed work-up must be carried out.
format	article
author	Vatsala Misra Ranjan Agrawal Sri Praksh Misra
author_facet	Vatsala Misra Ranjan Agrawal Sri Praksh Misra
author_sort	Vatsala Misra
title	Portal hypertensive vasculopathy – An entity worth remembering with non-neoplastic gastrointestinal lesions
title_short	Portal hypertensive vasculopathy – An entity worth remembering with non-neoplastic gastrointestinal lesions
title_full	Portal hypertensive vasculopathy – An entity worth remembering with non-neoplastic gastrointestinal lesions
title_fullStr	Portal hypertensive vasculopathy – An entity worth remembering with non-neoplastic gastrointestinal lesions
title_full_unstemmed	Portal hypertensive vasculopathy – An entity worth remembering with non-neoplastic gastrointestinal lesions
title_sort	portal hypertensive vasculopathy – an entity worth remembering with non-neoplastic gastrointestinal lesions
publisher	Wolters Kluwer Medknow Publications
publishDate	2021
url	https://doaj.org/article/0561664bd06a464d912e427aff455177
work_keys_str_mv	AT vatsalamisra portalhypertensivevasculopathyanentityworthrememberingwithnonneoplasticgastrointestinallesions AT ranjanagrawal portalhypertensivevasculopathyanentityworthrememberingwithnonneoplasticgastrointestinallesions AT sriprakshmisra portalhypertensivevasculopathyanentityworthrememberingwithnonneoplasticgastrointestinallesions
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Portal hypertensive vasculopathy – An entity worth remembering with non-neoplastic gastrointestinal lesions

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