Dulai G S, Jensen D M, Kovacs T O G, Gralnek I M, Jutabha R
Center for Ulcer Research and Education, Digestive Disease Research Center, Center for the Study of Digestive Healthcare Quality and Outcomes, University of California at Los Angeles School of Medicine, Los Angeles, California, USA.
Endoscopy. 2004 Jan;36(1):68-72. doi: 10.1055/s-2004-814112.
Watermelon stomach is a source of recurrent gastrointestinal hemorrhage and anemia. The aims of this study were to describe the endoscopic appearance and treatment outcomes in watermelon stomach patients with and without portal hypertension.
All patients with watermelon stomach enrolled in a hemostasis research group's prospective studies from 1991 to 1999 were identified. Investigators collected data using standardized forms. Comparisons were made using the chi-squared test, Wilcoxon rank-sum test, and Wilcoxon signed-rank test.
Twenty-six of 744 (4 %) consecutively enrolled patients with nonvariceal upper gastrointestinal hemorrhage had watermelon stomach as the cause. Eight of these 26 patients (31 %) also had portal hypertension. These patients had diffuse antral angiomas, as opposed to the classic linear arrays seen in those without portal hypertension. The demographic data and clinical presentations of the two groups were otherwise similar. Palliative endoscopic treatment was associated with a significant rise in hematocrit and a decrease in the need for blood transfusion or hospitalization in watermelon stomach patients with and without portal hypertension.
Watermelon stomach patients with and without portal hypertension had similar clinical presentations. The endoscopic findings differed in that those with portal hypertension had more diffuse gastric angiomas. Bleeding was effectively palliated by endoscopic treatment, regardless of the presence of portal hypertension.
西瓜胃是反复发生胃肠道出血和贫血的一个病因。本研究的目的是描述有无门静脉高压的西瓜胃患者的内镜表现及治疗结果。
确定了1991年至1999年参加一个止血研究组前瞻性研究的所有西瓜胃患者。研究人员使用标准化表格收集数据。采用卡方检验、Wilcoxon秩和检验和Wilcoxon符号秩检验进行比较。
在744例连续入选的非静脉曲张性上消化道出血患者中，26例（4%）病因是西瓜胃。这26例患者中有8例（31%）也有门静脉高压。这些患者有弥漫性胃窦血管瘤，与无门静脉高压患者所见的典型线性排列不同。两组的人口统计学数据和临床表现其他方面相似。姑息性内镜治疗使有无门静脉高压的西瓜胃患者的血细胞比容显著升高，输血或住院需求减少。
有无门静脉高压的西瓜胃患者临床表现相似。内镜检查结果的不同之处在于，有门静脉高压的患者胃血管瘤更弥漫。无论有无门静脉高压，内镜治疗都能有效缓解出血。
