Argon Plasma Coagulation in Treatment of Congestive Gastropathy in Patients with Liver Cirrhosis

Portal hypertensive gastropathy (PHG) is a collective term that defines an array of diffuse macroscopic lesions observed in the gastric mucosa of patients with portal hypertension. It is generally diagnosed on the basis of endoscopic feature. PHG is associated with mucosal and submucosal angiogenesis, vascular ectasia and dilation. Histologic confirmation is needed when the lesions are not characteristic or when other conditions such as gastric antral vascular ectasia (GAVE), Helicobacter pylori infection, or drug-induced mucosal lesions need to be excluded and to follow up the effect of certain therapeutic applications on tissue level.Argon plasma coagulator (APC) is a new thermal modality that is intended for thermal coagulation of tissue. It has the major advantage that the depth of coagulation is automatically limited by a thin, electrically insulating layer which develops due to desiccation of the superficial tissue layer. Hemostasis is a main target for the use of APC and its role in ceasing PHG related acute and chronic bleeding is being studied in the past few years.This study was performed to evaluate the role of argon plasma coagulation in comparison to non selective beta blockers for the treatment of chronic blood loss and iron deficiency anemia in cirrhotic patients with severe portal hypertensive gastropathy.This study was done on 60 cirrhotic anemic patients diagnosed endoscopically as having severe PHG. They included 39 males and 21 females. Their ages ranged from 23 to 78 year old. All other possible causes of anemia were excluded.