THE STOMACH IN CIRRHOSIS - THE LEGEND OF PROTEUS RETOLD

Portal hypertensive gastropathy (PHG) and gastric antral vascular ecta sia (GAVE) (watermelon stomach) are increasingly recognized as separat e nosological entities detectable by careful upper gastrointestinal en doscopy and meticulous histological assessment. They have a significan t phenomenological overlap; both usually present with gastric mucosal hemorrhage and have a striking association with cirrhosis. However, th e distinct endoscopic and histological features, which are discussed i n this paper, enable physicians to differentiate PHG from GAVE. Portal hypertension as the prerequisite of PHG necessitates surgical (portos ystemic shunting) or medical (beta-blockade) portal decompressive ther apy, whereas the angiodysplasia-like lesions in watermelon stomach are successfully treated by electrocoagulation or laser therapy.