GASTRIC ENDOSCOPIC FEATURES IN PATIENTS WITH LIVER-CIRRHOSIS - CORRELATION WITH ESOPHAGEAL-VARICES, INTRAVARICEAL PRESSURE, AND LIVER DYSFUNCTION

This study was aimed at evaluating the gastric endoscopic features in patients with liver cirrhosis and at assessing whether endoscopic find ings correlated with the severity of portal hypertension and of the un derlying liver disease. We studied 394 cirrhotic patients and 110 cont rols. Prevalence of a mosaic-like pattern of the gastric mucosa was si gnificantly higher in cirrhotics than controls (80.5 vs. 0.9%; p < 0.0 01). Red spots of the gastric mucosa were found in 8.1% of cirrhotic p atients and in none of the control subjects. Erosions and petechiae we re found in 14.5 and 5.4% of the control population, but their prevale nce was significantly higher in cirrhotics (28.7 and 12.7%, respective ly; p < 0.05). Severity of the mosaic-like pattern as well as the pres ence of red spots were closely related to the size and hemorrhagic ris k of esophageal varices and to the presence of fundic varices. Also, s evere mosaic-like patterns were found more frequently in patients with severe impairment of liver function, as assessed by the Child-Pugh's criteria. Furthermore, the mosaic-like pattern was more severe in cirr hotic patients with a higher degree of portal hypertension as indirect ly assessed by measurement of esophageal intravariceal pressure. In co nclusion, (1) a mosaic-like pattern and red spots of the gastric mucos a are the only specific signs of congestive gastropathy in liver cirrh osis, and (2) the severity of the mosaic-like pattern correlates with the severity of liver dysfunction and of portal hypertension.