A 60 years old physician known to

have liver cirrhosis presented with

anemia. He had esophageal varices

which were banded few months ago

with total variceal obliteration.

Helicobacter disease

NSAIDS

Physiologic stress

Excess gastric acid

Common in patients who are hospitalized for life-threatening non bleeding illness

Primary ulcer prophylaxis with anti-secretory medications are recommended in such patients

Although congestive gastropathy is common in patients with portal hypertension, its uncommon cause of severe bleeding in such patients.

Usually occurs in patients with Liver Cirrhosis and systemic sclerosis

Treated by endoscopic coagulation

Linear mucosal ulcerations resulting from forceful vomiting causing gastric mucosal tear.

Hiatal hernia is an important predisposing factor.

Dilated aberrant submucosal vessel that erodes overlying epithelium in absence of primary ulcer.

Usually occur in male patients with comorbidities including CVD, CKD, alcohol and NSAIDS abuse.

Should be considered in any patients with upper GI bleeding and recent history of biliary tract interventions and cholangiocarcinoma

The classic triad: biliary colic, obstructive jaundice and GI bleeding.

Usually represents advanced stage, with mucosal ulceration

Suspected in patients with upper GI bleeding and history of thoracic and abdominal aortic aneurysm.