Review articlesDifferences between sporadic hyperplastic gastric polyps and portal hypertensive gastric polyps: a reviewHéroin, Lucilea; Saviano, Antonioa,b,c; Fenouil, Tanguyd; Sosa-Valencia, Leonardoe; Baumert, Thomas F.a,b,c; Habersetzer, Françoisa,b,c; Mayer, Pierrea,b Author Information aGastroenterology and Hepatology Unit, Hôpitaux Universitaires de Strasbourg bUniversité de Strasbourg cInserm, U1110, Institut de Recherche sur les Maladies Virales et Hépatiques, Strasbourg dInstitute of Pathology Est, Hospices Civils de Lyon, Lyon eIhu Strasbourg - Institute of Guided Image Surgery, Strasbourg, France Received 13 April 2021 Accepted 15 July 2021 Correspondence to Lucile Heroin, MD, Gastroenterology and Hepatology Unit, Hôpitaux Universitaires de Strasbourg, 1 quai Louis Pasteur, 67000 Strasbourg, France, Tel: +33666666666; e-mail: [email protected] European Journal of Gastroenterology & Hepatology: March 2022 - Volume 34 - Issue 3 - p 260-266 doi: 10.1097/MEG.0000000000002278 Buy Metrics 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. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.