Abstract: Objective: To investigate the clinical diagnosis of acute hemorrhagic portal hypertensive gastropathy (PHG) and to analyze the endoscopic appearance and therapeutic outcome in PHG patients. Methods: Clinical data, endoscopic results and outcome of 196 patients with upper gastrointestinal bleeding caused by portal hypertension in Ruijin Hospital North were collected and analyzed. Results: Sixty-seven patients with PHG were verified by endoscopy, which comprised 34.2% of total patients, including 49 patients with mild PHG (25.0%), 18 patients with severe PHG(9.2%); 5 patients (2.6%) with gastrointestinal bleeding were caused by severe PHG solely, which were verified by endoscopy, and 13 patients (6.6%) with bleeding were partially caused by severe PHG. All of the acute bleeding caused by severe PHG were stopped after therapy with vasoactive agents and endoscopic sclerotherapy. Conclusions: PHG is common in patients with portal hypertension. Mild PHG usually does not tend to cause bleeding, but its progression merits attention. The main endoscopic pattern of severe PHG is extensive cherry-red spots and diffuse hemorrhagic gastritis, which may lead to massive upper gastrointestinal bleeding. Treatment for reducing portal hypertension can effectively control bleeding caused by PHG.

Key words: Portal hypertensive gastropathy, Cirrhosis, Upper gastrointestinal hemorrhage, Diagnosis