LATE-STAGE CONGESTIVE GASTROPATHY

Gastric mucosal abnormalities resulting from portal hypertension are d efined as ''congestive gastropathy''. A case of congestive gastropathy with unusual features, in a 63 year old man with a history of excessi ve alcohol intake and cirrhosis, is described. The patient underwent a subtotal gastrectomy because of profuse bleeding from a gastric ulcer , providing a large surgical specimen for examination. Unusual gross a nd histological findings included prominent arterial intimal hyperplas ia, and diffuse duplication and focal fragmentation of the internal la mina elastica. The differential diagnosis of this condition includes p rimary angiodysplastic gastropathy such as Dieulafoy's disease. The si milarity with Dieulafoy-like angiodysplasia emphasises that clear cut criteria to define gastric vascular lesions do not yet exist.