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Portal Gastropathy and Bleeding Polyps in Cirrhosis Case Study


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.


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:



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.


Obesity and Fatty Liver Disease

Obesity, and all of its related complications, is more serious than most adults in America believe. More than one-third (34.9% or 78.6 million) of U.S. adults are obese. Obesity-related conditions include heart disease, stroke, type 2 diabetes, fatty liver disease, and certain types of cancer, are some of the leading causes of preventable death. We are seeing an increase in the number of young children and adolescents developing obesity, and all of the related complications.

The cost of obesity is staggering, with annual medical cost of obesity exceeding $147 billion in 2008 U.S. dollars. The medical costs for people who are obese were $1,429 higher than those of normal weight.

Dr. Galati and the Liver Specialists of Texas team are dedicated to evaluate, treat, and manage all aspects of obesity and non-alcoholic fatty liver disease (NAFLD and NASH), including the complication of cirrhosis and liver failure. Developing a customized plan of care for each patient they see is their objective.

Liver Transplant Resources

Dr. Galati has been involved in Liver Transplantation since 1989. As Medical Director for the Center for Liver Disease and Transplantation at Houston Methodist Hospital, Dr. Galati has cared for thousands of patients with advanced liver disease. In those with the most severe form of advanced liver disease and cirrhosis, liver transplantation is a life-saving surgery. For more information on liver transplantation, click here.

Indications for liver transplant include:

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