At a previous international Consensus Conference it was decided to define PHG as mild when only MLP of any grade was present, and severe when RPL,CRS or BBS were present. This decision was based on common experience of participants, but it was agreed that the definition was tentative and needed prospective evaluation One of the aims of the study was to ascertain whether mild and severe PHG are different in term of the risk of bleeding
Another important lesion seen in portal hypertensive patients is GVE. This is a distinct clinical, endoscopic and histopathologic entity reported in association with scleroderma, atrophic gastritis and cirrhosis of the liver. This lesion is characterized by aggregates of red spots. When these aggregates are arranged in a linear pattern in the antrum of the stomach, as in these pictures, the term gastric antral vascular ectasia (GAVE) or “watermelon stomach is used”. The ectatic red spots may be more diffuse and involve the proximal antrum as well when they are termed as the “diffuse” variety of GVE. When red spots are present within the mosaic mucosa, the term most often used to describe these changes is severe PHG. However, if the background mucosa have no mosaic appearance, the term used to describe these spots is gastric vascular ectasia (GVE) Thus it would appear that PHG can be diagnosed if the MLP lesion is the underlying lesion, otherwise the diagnosis is GVE. While it is considered a distinct entity from PHG, it may be seen in liver cirrhosis and the differential diagnosis might be difficult. In the Baveno classification GAVE is included and considered as a part of the PHG syndrome.