There was extensive vascular ectasia in the distal stomach. Portal hypertensive gastropathy and gastric antral vascular ectasias (GAVE) are both potential causes of upper GI bleeding. While they can be seen in patients with cirrhosis, it is quite uncommon to find them in the same patient. In portal hypertensive gastropathy, the mucosa is friable and bleeding occurs when the ectatic vessels rupture and manifest as mucosal oozing. The characteristic endoscopic appearance of fine white reticular pattern separating the areas of pinkish mucosa has been described as "snake skin". The pathogenesis of this disorder involves congestion and hyperemia of the mucosa.
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