Patel Anish, Patel Sunil, Wickremesinghe Prasanna C, Vadada Deepak
Department of Gastrointestinal Medicine, Richmond University Medical Center, Staten Island, NY, USA.
Clin Exp Gastroenterol. 2017 Jul 10;10:113-120. doi: 10.2147/CEG.S80241. eCollection 2017.
Gastric antral vascular ectasia (GAVE), also known as "watermelon stomach", is an uncommon condition, which can cause gastrointestinal bleeding due to rupture of blood vessels that line the stomach. The pathogenesis of GAVE remains unclear; however it is thought that hemodynamic changes, mechanical stress, and autoimmune factors all have a part to play. A range of conditions are also commonly associated with the syndrome, such as portal hypertensive gastropathy, liver cirrhosis, and autoimmune disorders. Less commonly, chronic renal failure, cardiac diseases, and bone marrow transplantation have coexisted with GAVE. The diagnosis is usually based on visualization of the tissue upon endoscopy; however, histology plays a role in uncertain cases. The typical "watermelon" appearance relates to the tissue having a striped appearance radiating out from the pylorus. Medical treatment has failed to show satisfactory results and surgery is usually considered as a last resort, due to its increased risk for complications and mortality. Lasers and argon plasma coagulation have been used recently, and been shown to be as effective as surgery and a safer option. We present three cases of gastric antral vascular ectasia treated at our institution with radiofrequency ablation and review the literature on treatment modalities for GAVE.
胃窦血管扩张症（GAVE），也被称为“西瓜胃”，是一种罕见病症，可因胃内血管破裂导致胃肠道出血。GAVE的发病机制尚不清楚；不过，人们认为血流动力学变化、机械应力和自身免疫因素都起到了一定作用。一系列病症也通常与该综合征相关，如门静脉高压性胃病、肝硬化和自身免疫性疾病。较少见的是，慢性肾衰竭、心脏病和骨髓移植与GAVE并存。诊断通常基于内镜检查时对组织的观察；然而，组织学在不确定的病例中发挥作用。典型的“西瓜”外观与从幽门向外辐射呈条纹状的组织有关。药物治疗未能显示出令人满意的效果，由于手术并发症和死亡率增加，通常被视为最后的手段。激光和氩离子凝固术最近已被使用，并已证明与手术效果相同且是更安全的选择。我们介绍了在我们机构接受射频消融治疗的三例胃窦血管扩张症病例，并回顾了关于GAVE治疗方式的文献。
