OJIM  Vol.3 No.2 , June 2013
Case report of gastric antral vascular ectasia (GAVE)
Abstract: Gastric antral vascular ectasia (GAVE) is a rare clinical disease which can cause recurrent upper gastrointestinal (GI) tract bleeding. It is responsible for about 4% of non-variceal upper GI haemorrhages. As one of the vascular diseases that happened in stomach, GAVE was also named as watermelon stomach (WS) for its characteristic endoscopic performance. Compared with portal hypertensive gastropathy (PHG) which with similar performances under endoscopy but often appeared as the result of portal hypertension, the etiology of GAVE is unknown. Recent years with further research it received several presumptions according to its histopathological features. Here we will introduce the disease systematically through two cases.
Cite this paper: Liu, F. , Ji, F. , Jin, X. and Du, Y. (2013) Case report of gastric antral vascular ectasia (GAVE). Open Journal of Internal Medicine, 3, 76-80. doi: 10.4236/ojim.2013.32020.

[1]   Rider, J.A., Klotz, A.P. and Kirsner, J.B. (1953) Gastritis with veno-capillary ectasia as a source of massive gastric hemorrhage. Gastroenterology, 24, 118-123.

[2]   Jabbari, M., Cherry, R., Lough, J.O., et al. (1984) Gastric antral vascular ectasia: The water melon stomach. Gastroenterology, 87, 1165-1170.

[3]   Ward, E.M., Raimondo, M., Rosser, B.G., et al. (2004) Prevalence and natural history of gastric antral vascular ectasia (GAVE) in patients undergoing orthoptic liver transplantation. Journal of Clinical Gastroenterology, 38, 898-900. doi:10.1097/00004836-200411000-00013

[4]   Tobin, R.W., Hackman, R.C., Kimmey, M.B., et al. (1996) Bleeding from gastric antral vascular ectasia in marrow transplant patients. Gastrointestinal Endoscopy, 44, 223- 229. doi:10.1016/S0016-5107(96)70155-4

[5]   Sebastian, S., O’Morain, C.A. and Buckley, M.J. (2003) Review article: Current therapeutic options for gastric antral vascular ectasia. Alimentary Pharmacology & The rapeutics, 18, 157-165. doi:10.1046/j.1365-2036.2003.01617.x

[6]   Takahashi, T., Takuya, M., Oki, M., et al. (2006) Severe hemorrhage from gastric antral vascular ectasia developed in a patient with AML. International Journal of Hematology, 83, 467-468. doi:10.1532/IJH97.06052

[7]   Ripoll, C. and Garcia-Tsao, G. (2010) Management of gastropathy and gastric vascular ectasia in portal hypertension. Clinical Liver Disease, 14, 281-295. doi:10.1016/j.cld.2010.03.013

[8]   Stotzer, P.O., Willeri, R. and Kilander, A.F. (2002) Watermelon stomach: Not only an antral disease. Gastrointestinal Endoscopy, 55, 897-900. doi:10.1067/mge.2002.124558

[9]   Molina Infante, J., Hernández Alonso, M., Mateos, J.M., et al. (2009) Refractory gastric antral vascular ectasia extending to the proximal stomach. Revista Espanola de Enfermedades Digestivas, 101, 71-80. doi:10.4321/S1130-01082009000100013

[10]   Selinger, C.P. and Ang, Y.S. (2008) Gastric antral vascular ectasia (GAVE): An update on clinical presentation, pathophysiology and treatment. Digestion, 77, 131-137. doi:10.1159/000124339

[11]   Chaves, D.M., Sakai, P., Oliveira, C.V., et al. (2006) Watermelon stomach: Clinical aspects and treatment with argon plasma coagulation. Arquivos de Gastroenterologia, 43, 191-195. doi:10.1590/S0004-28032006000300007

[12]   Fuccio, L., Zagari, R.M., Serrani, M., Eusebi, L.H., Grilli, D., Cennamo, V., Laterza, L., Asioli, S., Ceroni, L. and Bazzoli, F. (2009) Endoscopic argon plasma coagulation for the treatment of gastric antral vascular ectasia-related bleeding in patients with liver cirrhosis. Digestion, 79, 143-150. doi:10.1159/000210087

[13]   Ito, M., Uchida, Y., Kamano, S., Kawabata, H. and Nishioka, M. (2001) Clinical comparisons between two subsets of gastric antral vascular ectasia. Gastrointestinal Endoscopy, 53, 764-770. doi:10.1067/mge.2001.113922

[14]   Spahr, L., Villeneuve, J.P., Dufresne, M.P., et al. (1999) Gastric antral vascular ectasia in cirrhotic patients: Absence of relation with portal hypertension. Gut, 44, 739- 742. doi:10.1136/gut.44.5.739

[15]   Quintero, E., Pique, J.M., Bombi, J.A., et al. (1987) Gastric mucosal vascular ectasias causing bleeding in cirrhosis. A distinct entity associated with hypergastrinemia and low serum levels of pepsinogen I. Gastroenterology, 93, 1054- 1061.

[16]   Vincent, C., Pomier-Layrargues, G., Dagenais, M., Lapointe, R., Letourneau, R., Roy, A., Pare, P. and Huet, P.M. (2002) Cure of gastric antral vascular ectasia by liver transplantation despite persistent portal hypertension: A clue for pathogenesis. Liver Transplantaion, 8, 717- 720. doi:10.1053/jlts.2002.34382

[17]   Aldin, E.S., Mourad, F. and Tfayli, A. (2012) Gastric antral vascular ectasia in a patient with GIST after treatment with imatinib: Case report and literature review. Japanese Journal of Clinical Oncology, 42, 447-450. doi:10.1093/jjco/hys032

[18]   Dunne, K.A., Hill, J. and Dixon, J.F. (2006) Treatment of chronic transfusion-dependent gastric antral vascular ectasia (watermelon stomach) with thalidomide. European Journal of Gastroenterology & Hepatology, 18, 455-456. doi:10.1097/00042737-200604000-00024

[19]   Disdier, P., Schleinitz, N., Perreard, M., et al. (1995) Dramatic improvement of watermelon stomach with alphainterferon. American Journal of Gastroenterology, 90, 1009-1010.

[20]   Tran, A., Villeneuve, J.P., Bilodeau, M., et al. (1999) Treatment of chronic bleeding from gastric antral vascular ectasia (GAVE) with estrogen-progesterone in cirrhotic patients: An open pilot study. American Journal of Gastroenterology, 94, 2909-2911. doi:10.1111/j.1572-0241.1999.01436.x

[21]   Cabral, J.E., Pontes, J.M., Toste, M., et al. (1991) Watermelon stomach: Treatment with a serotonin antagonist. American Journal of Gastroenterology, 86, 927-928.

[22]   Frager, J.D., Brandt, L.J., Frank, M.S., et al. (1988) Treatment of a patient with watermelon stomach using transendoscopic laser photocoagulation. Gastrointestinal Endoscopy, 34, 134-137. doi:10.1016/S0016-5107(88)71280-8

[23]   Jaime Poniachik, T., Zoltán Berger, F. and Araxi Manuguián G. (2012) Endoscopic band ligation, for gastric antral vascular ectasia. Report of two cases. Revista médica de Chile, 140, 364-367.

[24]   Kwan, V., Bourke, M.J., Williams, S.J., et al. (2006) Argon plasma coagulation in the management of symptomatic gastrointestinal vascular lesions: Experience in 100 consecutive patients with long-term follow-up. American Journal of Gastroenterology, 101, 58-63. doi:10.1111/j.1572-0241.2006.00370.x

[25]   Sato, T., Yamazaki, K. and Akaike, J. (2012) Endoscopic band ligation versus argon plasma coagulation for gastric antral vascular ectasia associated with liver diseases. Journal of Digestive Endoscopy, 24, 237-242. doi:10.1111/j.1443-1661.2011.01221.x

[26]   Dulai, G.S. and Jensen, D.M. (2006) Treatment of watermelon stomach. Current Treatment Options in Gastroenterology, 9, 175-180. doi:10.1007/s11938-006-0036-1