Jin Ting, Fei Bao-Ying, Zheng Wei-Hua, Wang Yong-Xiang
Ting Jin, Wenzhou Medical University, Wenzhou 325016, Zhejiang Province, China.
World J Gastroenterol. 2014 Oct 14;20(38):14073-5. doi: 10.3748/wjg.v20.i38.14073.
Gastric antral vascular ectasia (GAVE) is an uncommon and often neglected cause of gastric hemorrhage. The treatments for GAVE include surgery, endoscopy and medical therapies. Here, we report an unusual case of GAVE. A 72-year-old man with a three-month history of recurrent melena was diagnosed with GAVE. Endoscopy revealed the classical "watermelon stomach" appearance of GAVE and complete pyloric involvement. Melena reoccurred three days after argon plasma coagulation treatment, and the level of hemoglobin dropped to 47 g/L. The patient was then successfully treated with distal gastrectomy with Billroth II anastomosis. We propose that surgery should be considered as an effective option for GAVE patients with extensive and severe lesions upon deterioration of general conditions and hemodynamic instability.
胃窦血管扩张症（GAVE）是一种罕见且常被忽视的胃出血原因。GAVE的治疗方法包括手术、内镜检查和药物治疗。在此，我们报告一例不寻常的GAVE病例。一名72岁男性，有三个月反复出现黑便的病史，被诊断为GAVE。内镜检查显示出GAVE典型的“西瓜胃”外观以及幽门完全受累。氩离子凝固治疗三天后黑便再次出现，血红蛋白水平降至47g/L。该患者随后通过毕Ⅱ式吻合远端胃切除术成功治愈。我们建议，对于病情恶化且血流动力学不稳定、病变广泛且严重的GAVE患者，应考虑将手术作为一种有效的治疗选择。
