Abstract：
Portal hypertension (PH) is one of the most severe complications of chronic liver diseases. It is defined as an increase in pressure in the portal venous system which results in a portosystemic gradient >5 mmHg. In the western world, cirrhosis is the most frequent cause of PH, mainly due to nonalcoholic fatty liver disease and alcoholic liver disease. Patients with PH have esophageal varices in 68-73% of cases, portal hypertensive gastropathy in 51-73% and hyperplastic polyps (HPs) in 0.9-2%. Recent studies have shown that HPs found in PH patients are different from classical HPs. They constitute a new entity called portal hypertensive polyps (PHPs). The main difference between sporadic HPs and PHP is the presence of larger and more numerous vascular capillaries in the lamina propria. The clinical course of PHPs is unknown. Their physiopathology seems different from HPs: the increased congestion caused by higher portal pressure in the stomach may induce capillaries proliferation and neoangiogenesis. PHPs may be responsible for symptoms, such as pyloric obstruction, iron deficiency and anemia. Their prevalence in portal hypertensive and cirrhotic patients is from 1% to 8%. PHPs can be single or numerous, in the antrum or the gastric corpus. Their size ranges from 2 to 3 cm. PHPs seem to disappear or shrink with the treatment of PH. They should be resected in case of symptom and if >10 mm, after Helicobacter pylori eradication if present. However, their recurrence is frequent (40-79%), thus surveillance endoscopy is mandatory, at the same time as esophageal varices.
摘要：
门静脉高压症（PH）是慢性肝病最严重的并发症之一。它被定义为门静脉系统中压力的增加,其导致门体梯度>5mmHg。在西方世界,肝硬化是PH的最常见原因，主要是由于非酒精性脂肪性肝病和酒精性肝病。PH患者在68-73%的病例中有食管静脉曲张，门脉高压性胃病占51-73％，增生性息肉（HP）占0.9-2％。最近的研究表明，在PH患者中发现的HP不同于经典的HP。它们构成了一种称为门脉高压性息肉（PHPs）的新实体。零星的HP和PHP之间的主要区别是固有层中存在更大，更多的血管毛细血管。PHP的临床过程未知。他们的病理生理学似乎与HP不同：胃中较高的门静脉压力引起的充血增加可能会引起毛细血管增殖和新血管生成。PHP可能是症状的原因，比如幽门梗阻,缺铁和贫血。它们在门脉高压和肝硬化患者中的患病率为1％至8％。PHP可以是单个或多个，在胃窦或胃体。它们的尺寸范围从2到3厘米。PHP似乎随着PH的治疗而消失或缩小。如果出现症状，应将其切除，如果>10毫米，根除幽门螺杆菌后，如果存在。然而,复发频繁（40-79%），因此，监视内窥镜检查是强制性的，与食管静脉曲张同时发生。
