Gastric antral vascular ectasia is a relatively common endoscopic finding. Gastric antral vascular ectasia gave may occur after hematopoietic stem cell transplantation hsct and cause severe and prolonged gastric bleeding. During the following 4 months, the patient had 3 new episodes 3. It may lead to irondeficiency anaemia and transfusion dependence. Hemorrhage from extra antral gastric antral vascular ectasia in a patient with duodenal heterotopic gastric mucosa the harvard community has made this article openly available.
Gastric antral vascular ectasia gave is an uncommon but often severe cause of upper gastrointestinal gi bleeding, responsible of about 4% of nonvariceal upper gi haemorrhage. Joseph galati, liver specialists of texas, based in houston, texas. Treating gastric antral vascular ectasia when argon. Gastric antral vascular ectasia watermelon stomach an enigmatic and oftenoverlooked cause of gastrointestinal bleeding in the elderly. It is also referred to as watermelon stomach because when we view it with an endoscope, the stomach lining has visible stripes that make it look similar to the striped skin of a watermelon. Whereas phg is associated with portal hypertension, gave may present in patients without portal hypertension or liver disease. Gave is rare and associated with a vascular phenotype, including antirnapolymerase iii antibodies, and a high risk of renal crisis. Gastric antral vascular ectasia a sages wiki article. Gave is an uncommon and often neglected cause of upper gastrointestinal gi bleeding. Hemorrhage from extraantral gastric antral vascular ectasia in a patient with duodenal heterotopic gastric mucosa the harvard community has made this article openly available. Gastric antral vascular ectasia syndrome is a rare entity. Subjects with early, diffuse ssc and evidence of specific internal organ involvement were considered for the scleroderma. The anemia caused by the chronic blood loss from the abnormally dilated mucosal and submucosal capillary veins in the gastric antrum was unresponsive to oral iron supplementation.
It is not a large, bloated or fat stomach as some people think it is. However, it was eventually defined in 1984 by jabbari and colleagues. Gastric antral vascular ectasia gave, also known as watermelon stomach, is a rare condition affecting the stomach. The condition is associated with dilated small blood vessels in the pyloric antrum, which is a distal part of the stomach. Treatment of gastropathy and gastric antral vascular. Successful treatment of gave continues to be a challenge and has evolved through the years. Gastric antral vascular ectasia in systemic sclerosis article pdf available in international journal of rheumatology 201116879260. A distinct vascular lesion in the pyloric antrum that is characterized by tortuous dilated blood vessels ectasia radiating outward from the pylorus. Gave gastric antral vascular ectasia is a particular form of gastropathy associated with chronic gi bleeding and iron deficiency anemia. Gastric antral vascular ectasia gave is traditionally considered an endoscopic diagnosis. To evaluate patients with systemic sclerosis ssc who have gastric antral vascular ectasia gave, to further characterize this disease association, and to identify factors that may predict which patients with ssc are at greatest risk for the development of gave. Gastric antral vascular ectasia gave may be an enigmatic source of nonvariceal upper gi bleeding associated with various systemic diseases such as connective tissue disorders, liver disease, and chronic renal failure. It has been associated with systemic sclerosis but the. Two patients with severe iron deficiency anemia and gastric antral vascular ectasia gave are reported.
Gastric antral vascular ectasia how is gastric antral. Understanding hemostasis for gastric antral vascular ectasia gave and radiation proctitis rp the purpose of this module is to create awareness of the bleeding disorders gave and radiation proctitis, discuss why they occur and explore the treatment options available to patients. Gastric antral vascular ectasia and portal hypertensive. Gastric antral vascular ectasia gave is a rare but an important cause of upper gastrointestinal bleeding ugib and commonly presents as. Wheelar was the first person to diagnose this condition in 1979. Databases medline, scopus, embase, pubmed, and cochrane were searched for relevant papers. Gave gastric antral vascular ectasia, also known as watermelon stomach, is a condition in which the blood vessels in the lining of the stomach become fragile and become prone to rupture and bleeding. Past studies have shown an association of gastric antral vascular. Red spots radially departing from pylorus and involving the gastric antrum. Anemia, usually requiring blood transfusions, is a common complication. Radiofrequency ablation for gastric antral vascular ectasia. Because the role of the gastric biopsy is uncertain, and the relatively obscure criteria proposed by gilliam dig dis sci 1989.
Hien nguyen, md, is an internist at the camp springs medical center in temple hills, md, and an attending internist at the washington hospital center in washington, dc. Two cases of gastric antral vascular ectasiaresponse to. Treatment of gastropathy and gastric antral vascular ectasia. The diagnosis is mainly based on endoscopic pattern and, for uncertain cases, on histology. Sep 20, 2014 gave gastric antral vascular ectasia is a particular form of gastropathy associated with chronic gi bleeding and iron deficiency anemia. The need to accurately characterize these two conditions is dependent on. This condition can be associated with some other diseases such as cirrhosis, autoimmune diseases and others. Gastric antral vascular ectasia gave is an uncommon but important cause of chronic gastrointestinal bleeding.
Gastric antral vascular ectasia gave is an uncommon cause of chronic gastrointestinal bleeding or iron deficiency anemia. Pathology outlines gastric antral vascular ectasia gave. The vessel pattern resembles the stripes on the surface of a watermelon. Portal hypertensive gastropathy phg and gastric antral vascular ectasia gave are two distinct gastric mucosal lesions that may cause acute andor chronic upper gastrointestinal hemorrhage in patients with cirrhosis. Jan 16, 20 gastric antral vascular ectasia gave is an uncommon but often severe cause of upper gastrointestinal gi bleeding, responsible of about 4% of nonvariceal upper gi hemorrhage. The watermelon stomach mansour jabbari, raeleen cherry, john o. Watermelon stomach gastric antral vascular ectasia. Prevalence, correlates and outcomes of gastric antral vascular ectasia gave in systemic sclerosis. Your story matters citation gubatan, john, nathan raines, hasan khosravi, tracy l. Here are links to possibly useful sources of information about gastric antral vascular ectasia. Gastric antral vascular ectasia gave is an erratic cause of chronic upper gastrointestinal bleeding. Review article gastric antral vascular ectasia in systemic.
Treating gastric antral vascular ectasia when argon therapy is not enough 251 figure 2 gastric antral vascular ectasia after apc treatment. Gastric antral vascular ectasia gave is an uncommon but often severe cause of upper gastrointestinal gi bleeding, responsible of about 4% of nonvariceal upper gi hemorrhage. Gastric antral vascular ectasia prime health channel. The stomach lining exhibits the characteristic stripes of a watermelon when viewed by endoscopy. Ideal sources for wikipedia s health content are defined in the guideline wikipedia. Rare acquired vascular disease that may cause blood loss and iron deficiency anemia due to chronic antral hemorrhage associated with connective tissue diseases, particularly systemic sclerosis, but etiology unclear arch pathol lab med 2002. This disease was first described in 1953 by ryder et al, but deeply investigated only 25 years later, in 1978, by van vliet et al. Pdf gastric antral vascular ectasia in systemic sclerosis. Clinical characterization of gastric antral vascular ectasia. T1 medical and endoscopic therapies for angiodysplasia and gastric antral vascular ectasia. Despite the name, watermelon stomach is not a pleasant medical condition, by any means, and due to its severity, it is important to be able to recognize the symptoms and causes of this unusual disorder. Mar 22, 2018 watermelon stomach, medically known as gastric antral vascular ectasia gave, is a condition where a person suffers from chronic gastrointestinal bleeding leading to iron deficiency anemia. Patients with a diagnosis of both ssc and gave were identified from the division of rheumatology at georgetown. Understanding hemostasis for gastric antral vascular ectasia.
Watermelon stomach gastric antral vascular ectasia gave. Watermelon stomach gastric antral vascular ectasia gave is a condition in which the blood vessels in the stomach become overly dilated, causing intestinal bleeding. Goresky division of gastroenterology, department of medicine, montreal general hospital and mcgill university, montreal, quebec, canada. We present two cases of gave, one with pernicious anaemia associated and the other is portal.
Gastric antral vascular ectasia or watermelon stomach is a rare cause of chronic gastrointestinal bleeding, often presenting as a chronic iron deficiency anemia. Although first described in 1953 by rider, the disease was actually discovered a year earlier in 1952. Gastric antral vascular ectasia gave and portal hypertensive gastropathy phg are mucosal lesions that can cause chronic gastrointestinal bleeding in the patients with cirrhosis. Medical and endoscopic therapies for angiodysplasia and. Diagnosing watermelon stomach can be achieved through various tests, such as an endoscopy, biopsy, and ultrasound, among others. Gastric antral vascular ectasia how is gastric antral vascular ectasia abbreviated. It is present in 3% of cirrhotics, whereas 3040% of gave patients have portal hypertension. Figure 1 endoscopic appearance of gastric antral vascular ectasia. Gastrointestinal angiodysplasia giad is a benign condition caused by vascular malformation, usually in the large, and sometimes, in the small intestine.
The sections show antral type gastric mucosa with dilated lamina propria blood vessels and intravascular fibrin thrombi. Gastric antral vascular ectasia gave syndrome is an uncommon cause of chronic gastrointestinal bleeding as well as iron deficiency anaemia. Pdf gastric antral vascular ectasia and portal hypertensive. It has been associated with systemic sclerosis but the pathophysiological changes leading to gave have not been explained and still remain uncertain. Gastric antral vascular ectasia gave, also referred to as watermelon stomach, is an uncommon, underreported, yet significant. This disease was first described in 1953 by ryder et al 2, but deeply investigated only 25 years later, in 1978, by van vliet et al 3. Gastric antral vascular ectasia gave syndrome, also known as watermelon stomach is a significant cause of acute or chronic gastrointestinal blood loss in the. However, one of the patients was successfully treated with intramuscular injection of asu17 eel.
It is one of the diagnoses to consider in older patients with severe anemia and occult or profuse gastrointestinal bleeding especially in those with cardiac, liver, or renal diseases it can be a significant cause of severe acute or chronic gastrointestinal blood loss in the. Gastric antral vascular ectasia in systemic sclerosis. Gastric antral vascular ectasias gave 2 of 6 video. While phg occurs exclusively in patients with liver cirrhosis, gave can also present in patients with systemic and autoimmune conditions. To describe the prevalence and clinical correlates of endoscopic gastric antral vascular ectasia gave.
The etiology of gave has not been fully explored and remains controversial. Watermelon stomach or gastric antral vascular ectasia gave. Figure 2 videocapsule image of gastric antral vascular ectasia. Gastric antral vascular ectasia gave, called watermelon stomach is rare and has been reported as a cause of nonvariceal gastrointestinal bleeding in 4% of.
It consists of dilated small blood vessels in the antrum, which can present at endoscopy as watermelon stomach parallel longitudinal stripes converging to the pilorus or as diffuse ectasia of vessels. Apr 05, 2012 gastric antral vascular ectasia history. It can present with occult bleeding requiring transfusions or with acute gastrointestinal bleeding. Watermelon stomach, medically known as gastric antral vascular ectasia gave, is a condition where a person suffers from chronic gastrointestinal bleeding leading to iron deficiency anemia. Pdf gastric antral vascular ectasia gave and portal hypertensive gastropathy phg are mucosal lesions that can cause chronic gastrointestinal. Gastric antral vascular ectasia watermelon stomachan. Successful treatment of refractory gastric antral vascular.
Watermelon stomach or gastric antral vascular ectasia. Treating gastric antral vascular ectasia when argon therapy. Since then, a better but still incomplete knowledge of this. Hemorrhage from extraantral gastric antral vascular. Although the pathogenesis of this condition is largely unknown, it is associated with a number of medical conditions including portal.
Endoscopic image of gastric antral vascular ectasia although gave is considered a rare medical condition, it accounts for up to 4% of all nonvariceal upper gastrointestinal bleeds. Diagnosis and management of gastric antral vascular ectasia. Gastric antral vascular ectasia radiology reference article. Gastric carcinoma 5% benign gastric ulceration 5% angiodysplasia 5% uncommon oesophagitis 2e4% oesophageal carcinoma 1e2% gastric antral vascular ectasia 1e2% small bowel tumours 1e2% cameron ulcer in large hiatus hernia esophagitis in 35. Endoscopic treatment for gastric antral vascular ectasia. Radiofrequency ablation for gastric antral vascular ectasia information for the public published. The procedure is safe enough for use in the nhs, but there is not much good evidence about how well it works. It is one of the diagnoses to consider in older patients with severe anemia and occult or profuse gastrointestinal bleeding especially in those with cardiac, liver, or renal diseases. Understanding hemostasis for gastric antral vascular. The topic gastrointestinal vascular ectasia you are seeking is a synonym, or alternative name, or is closely related to the medical condition gastrointestinal angiodysplasia. Gastric antral vascular ectasia gave syndrome is a rare but relevant entity that may lead to upper gastrointestinal gi bleeding.
Gastric antral vascular ectasia gave is a rare cause of upper gastrointestinal gi bleeding, accounting for 4% of nonvariceal upper gi bleeding and associated with occult bleeding that manifests as iron deficiency anemia. Typical initial presentations range from occult bleeding causing transfusiondependent chronic irondeficiency anemia to severe acute uppergastrointestinal bleeding. Gave is a rare entity in the spectrum of manifestations of systemic sclerosis with unknown pathogenesis. Gastric antral vascular ectasia gave is a rare entity with unique endoscopic appearance described as watermelon stomach. The condition is associated with dilated small blood vessels in the. Dec 01, 2014 gastric antral vascular ectasia gave is an uncommon cause of chronic gastrointestinal bleeding or iron deficiency anemia. Dec 21, 2012 gastric antral vascular ectasia gave is a rare cause of upper gastrointestinal gi bleeding, accounting for 4% of nonvariceal upper gi bleeding and associated with occult bleeding that manifests as iron deficiency anemia. Gastric antral vascular ectasia gave is an uncommon but often severe cause of upper gastrointestinal gi bleeding, responsible of about 4%. This lesion causes both acute and chronic gastrointestinal hemorrhage. The person affected from water melon stomach has dilated small blood vessels in the last part of the stomach, which is the antrum. It is often associated with systemic diseases such as autoimmune diseases, liver cirrhosis, chronic renal insufficiency and cardiovascular disease. Vasudev, mb, mrcpath in the evaluation of chronic blood loss from the upper gastrointestinal tract vascular abnormalities are increasingly found, their diagnosis being facilitated by endoscopic and angiographic techniques.
Gastric antral vascular ectasia gave is a condition where the stomach lining bleeds in multiple locations. Watermelon stomach is the popular name for gastric antral vascular ectasia gave a condition in which the lining of the stomach bleeds, causing it to look like the characteristic stripes of a watermelon when viewed by endoscopy. Jul 21, 2014 gastric antral vascular ectasia gave is traditionally considered an endoscopic diagnosis. Gastric antral vascular ectasia gave syndrome, also known as watermelon stomach, is a rare but wellrecognised cause of chronic upper gastrointestinal blood loss. It is also called watermelon stomach because streaky long red areas that are present in the. Insights into the management of gastric antral vascular. Mar 15, 2008 portal hypertensive gastropathy phg and gastric antral vascular ectasia gave are two distinct gastric mucosal lesions that may cause acute andor chronic upper gastrointestinal hemorrhage in patients with cirrhosis. Know the causes, symptoms, treatment and diagnosis of watermelon stomach or gastric antral vascular ectasia gave. Introduction gastric antral vascular ectasia gave is a rare disorder characterised by upper gi bleeding, chronic irondeficiency anaemia and endoscopic findings of columns of red tortuous vessels along the longitudinal folds of the antrum of the stomach. Classic noncirrhotic patient is middleaged female with autoimmune disease or atrophic gastritis.
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