**3. Conclusions**

In the clinical scenario of gastroduodenal lesions associated with PH and liver cirrhosis, both are important actors, but the PH and hepatic chronic disease remain the protagonist of the clinical state. In fact the degree of functional hepatic impairment and of hypertensive status in the splanchnic district affect much the patients general conditions. Moreover the upper gastrointestinal bleeding is the more frequent complication of this complex pathological condition. Esophageal varices currently develop in the cirrhotics with PH and this is the characteristic source of gastrointestinal bleeding. However upper digestive hemorrhage in cirrhotic patients alwais requires the diagnostic definition of bleeding source, which may also be due to pathologies related to PH. In fact, albeit less frequently, others gastroduodenal lesions, with pathogenetic association to liver cirrhosis and PH, may present intestinal hemorrhage. The PHG is in several cases neglected complication of liver cirrhosis and PH. PHG is connected with the degree of PH and can have a role as prognostic index of liver cirrhosis. The management of PHG is based on pharmacological, endoscopic or, in some few cases, on emergency therapy with TIPS. GAVE can affect one third of cirrhotics. PHG and GAVE may both occur in patients with liver cirrhosis. However these pathologies have different pathophysiology and management. The central diagnostic aim is to distinguish GAVE from PHG because the therapeutic procedures that allow decrease of portal pressure, effective for PHG, are not efficacious therapy for GAVE, usually treated by endoscopic approach. Gastric and duodenal ulcer are more frequent in cirrhotics and may worsen prognosis. Early diagnosis and treatment of peptic ulcer in cirrhotic patients are significant to avoid complications. Gastric varices, usually connected with esophageal varices, can be, in some cases, isolated; their therapeutic approach in case of bleeding is enclosed within the effective management of gastrointestinal hemorrhage in the PH. In conclusion the complete diagnosis that identifies with certainty, the bleeding source is decisive for the therapeutic choices.

*Gastroduodenal Lesions Associated with Portal Hypertension: An Extensive Review DOI: http://dx.doi.org/10.5772/intechopen.96296*
