Portal hypertensive gastropathy (PHG) is common in gastrointestinal (GI) diseases, and a severe stage of PHG (S-PHG) is a source of gastrointestinal active bleeding. Generally, the diagnosis of PHG is made visually during endoscopic examination; compared with traditional endoscopy, (wireless capsule endoscopy) WCE with noninvasive and painless is chosen as a prevalent tool for visual observation of PHG. However, accurate measurement of WCE images with PHG is a difficult task due to faint contrast and confusing variations in background gastric mucosal tissue for physicians. Therefore, this paper proposes a comprehensive methodology to automatically detect S-PHG images in WCE video to help physicians accurately diagnose S-PHG. Firstly, a rough dominatecolor-tone extraction approach is proposed for better describing global color distribution information of gastric mucosa. Secondly, a hybrid two-layer texture acquisition model is designed by integrating co-occurrence matrix into local binary pattern to depict complex and unique gastric mucosal microstructure local variation. Finally, features of mucosal color and microstructure texture are merged into linear support vector machine to accomplish this automatic classification task. Experiments were implemented on an annotated data set including 1,050 SPHG and 1,370 normal images collected from 36 real patients of different nationalities, ages and genders. By comparison with three traditional texture extraction methods, our method, combined with experimental results, performs best in detection of S-PHG images in WCE video: the maximum of accuracy, sensitivity and specificity reach 0.90, 0.92 and 0.92 respectively.