Io H, Takeda Y, Okumura K, Sakamoto N, Obayashi K, Suzuki S, Funabiki K, Horikoshi S, Shirato I, Tomino Y
Division of Nephrology, Department of Medicine, Juntendo University School of Medicine, Tokyo, Japan.
Nihon Jinzo Gakkai Shi. 2001;43(2):82-7.
A 76-year-old woman was admitted to our hospital complaining of tarry stool, general fatigue and marked anemia(Hb 5.2 g/dl). Gastric endoscopic findings showed longitudinal red stripes and diffuse erythematous spots, indicating dilated vascular vessels. They resembled the stripes of a watermelon at the gastric antrum. The marked anemia was caused by chronic blood loss from the abnormally dilated mucosal and submucosal capillary veins in the gastric antrum. She was diagnosed as having gastric antral vascular ectasia(GAVE) with chronic renal failure(CRF). The association of GAVE and CRF is considered to be rare according to previous reports in Japan. Endoscopic argon plasma coagulation therapy was performed three times. After therapy, capillary dilatation disappeared, and the marked anemia was greatly improved. Argon plasma coagulation therapy was found to be a safe and effective procedure for this disease. Although GAVE is essentially a benign gastric disease, endoscopic therapy should be the treatment of first choice for this disease.
一名76岁女性因黑便、全身乏力和明显贫血(血红蛋白5.2g/dl)入院。胃镜检查发现胃内有纵向红色条纹和弥漫性红斑,提示血管扩张。它们类似于胃窦部的西瓜条纹。明显的贫血是由胃窦部异常扩张的黏膜和黏膜下毛细血管静脉慢性失血所致。她被诊断为胃窦血管扩张症(GAVE)合并慢性肾衰竭(CRF)。根据日本以往的报道,GAVE与CRF的关联被认为是罕见的。进行了三次内镜氩离子凝固治疗。治疗后,毛细血管扩张消失,明显的贫血得到了极大改善。氩离子凝固治疗被发现是治疗这种疾病的一种安全有效的方法。虽然GAVE本质上是一种良性胃部疾病,但内镜治疗应该是这种疾病的首选治疗方法。