A 55-year-old woman with Child-Pugh B alcoholiccirrhosis and ongoing excessive use of alcohol (50 units/week) presented with hematemesis and melena, hemodynamic instability, acute anemia (hemoglobin 98 g/L), stablehyperbilirubinemia, coagulopathy (international normalizedratio [INR] 1.9), Model for End-stage Liver Disease (MELD)score 22, and Blatchford score of 16. After resuscitation,reversal of coagulopathy, and empirical variceal measureswith intravenous terlipressin and gram-negative antibiotics,urgent endoscopy was undertaken (Video 1, available onlineat www.VideoGIE.org). Gastroscopy excluded gastroesophageal varices but demonstrated widespread oozing in theantrum without a localized bleeding source (Fig. 1), withunderlying snakeskin mucosa characteristic of portal hypertensive gastropathy (PHG).
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机译：一名55岁的Child-Pugh B酒精性肝硬化妇女，持续饮酒（50单位/周），表现为呕血和黑便，血流动力学不稳定，急性贫血（血红蛋白98 g / L），稳定的高胆红素血症，凝血病（国际标准化比率） [INR] 1.9），终末期肝病模型（MELD）得分22，Blatchford得分为16。复苏，凝血病逆转以及静脉滴注特利加压素和革兰氏阴性抗生素的经验性静脉曲张措施后，进行了紧急内镜检查（视频1，可从www.VideoGIE.org在线获得）。胃镜检查排除了胃食管胃底静脉曲张，但显示出肛门处广泛渗血，而没有局部出血源（图1），并具有门脉高压性胃病（PHG）的蛇皮粘膜特征。
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