Gastric antral vascular ectasia
| Gastric antral vascular ectasia | ||
 | ||
|---|---|---|
| Endoscopic image of gastric antral vascular ectasia seen as a radial pattern around the pylorus before (top) and after (bottom) treatment with argon plasma coagulation | ||
| DiseasesDB | 29505 | |
| MeSH | C06.405.748.280 | |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: Watermelon stomach; GAVE
Overview
Gastric antral vascular ectasia is an uncommon cause of chronic gastrointestinal bleeding or iron deficiency anemia. The condition is associated with dilated small blood vessels in the antrum, or the last part of the stomach. It is also called watermelon stomach because streaky long red areas that are present in the stomach may resemble the markings on watermelon[1].
Historical Perspective
The condition was first discovered in 1952, and reported in the literature in 1953.[2] Watermelon disease was first diagnosed by Wheeler et al. in 1979, and definitively described in four living patients by Jabbari et al. only in 1984. As of 2011, the etiology and pathogenesis are still not known.[3] However, there are several competing hypotheses as to various etiologies.
Pathophysiology
GAVE is characterized by dilated capillaries in the lamina propria with fibrin thrombi.
Asociated Conditions
GAVE is associated with a number of conditions, including
Differentiating Gastric antral vascular ectasia from other Diseases
GAVE should be differentiated from other causes of intestinal bleeding such as
The differential diagnosis is important because treatments are different.
Diagnosis
Symptoms
Endoscopy
The endoscopic appearance of GAVE is similar to portal hypertensive gastropathy. Dilated capillaries are seen in the endoscopy which resemble the tell-tale watermelon stripes.
Treatment
GAVE is treated with treatment through the endoscope, including argon plasma coagulation and electrocautery. Other medical treatments have been tried and include estrogen and progesterone therapy and anti-fibrinolytic drugs such as tranexamic acid.
References
- ↑ Suit P, Petras R, Bauer T, Petrini J (1987). "Gastric antral vascular ectasia. A histologic and morphometric study of "the watermelon stomach"". Am J Surg Pathol. 11 (10): 750–7. PMID 3499091.
- ↑ Rider, JA; Klotz, AP; Kirsner, JB (1953). "Gastritis with veno-capillary ectasia as a source of massive gastric hemorrhage". Gastroenterology. 24 (1): 118–23. PMID 13052170.
- ↑ Tuveri, Massimiliano; Borsezio, Valentina; Gabbas, Antonio; Mura, Guendalina (2007). "Gastric antral vascular ectasia—an unusual cause of gastric outlet obstruction: report of a case". Surgery today. 37 (6): 503–5. doi:10.1007/s00595-006-3430-3. PMID 17522771.
- ↑ Spahr, L; Villeneuve, J-P; Dufresne, M-P; Tasse, D; Bui, B; Willems, B; Fenyves, D; Pomier-Layrargues, G (1999). "Gastric antral vascular ectasia in cirrhotic patients: absence of relation with portal hypertension". Gut. 44 (5): 739. doi:10.1136/gut.44.5.739. PMC 1727493. PMID 10205216.