Portal Gastropathy and Bleeding Polyps in Cirrhosis Case Study Print View

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Overview

This is the case of a 57 year old man with cirrhosis and portal hypertension. He was referred to me for further evaluation of his chronic anemia and suspected GI bleeding. Prior endoscopy by his referring gastroenterologist felt he has gastric varicies, and that he needed a transjugular shunt, also known as TIPSS.

He was requiring blood transfusions every two weeks, and was iron deficient. In a year, he received over 30 units of blood.

His underlying liver disease was well compensated, and he had no other complicating factors, such as hepatic encephalopathy, ascites, or wasting.

Execution

I performed an upper endoscopy, and found numerous bleeding polyps, part of a spectrum of portal gastropathy and portal enteropathy. The suspected gastric varices were large bleeding polyps.

Here is the video and description of the case:

Results

After the initial endoscopy, the bleeding stopped, and his blood remained stable, requiring no further blood transfusions.

This case illustrated that bleeding polyps in the stomach, related to portal gastropathy, and portal enteropathy, can be treated with successful band ligation of these polyps.