The honeycomb stomach: coalesced gastric angiodysplasia

Chawla, S.K.; Ramani, Komal; Presti, Philip Lo

doi:10.1016/s0016-5107(90)71131-5

Cited by 22 publications

(11 citation statements)

References 18 publications

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“…The presence of ischaemic heart disease in most ofour patients (six of eight) could be attributed either to the fact that some of them have been referred from other centres, considered unfit for surgery, or by a possible correlation of the vascular abnormalities with generalised atherosclerosis.7 It is presumed these lesions are related to chronic hypo-oxygenation of the microcirculation resulting from low cardiac output or decreased pulse pressure, or both as is found in aortic stenosis. 4 The presence of DGAVE in patients with renal insufficiency has been reported in other studies4'3 and the association of renal insufficiency with angiodysplasia is well established. '5 Two of our patients had chronic renal failure and this seems to be more than coincidental.…”

Section: Discussionmentioning

confidence: 58%

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Endoscopic laser treatment of diffuse gastric antral vascular ectasia.

Potamiano

Carter

Anderson

1994

Gut

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Eight patients (six women and two men) were found to have iron deficiency anaemia due to diffuse gastric antral vascular ectasia. The mean age of the patients was 74-6 years (range 57-83). AU required repeated blood transfusions (mean 18 units/year) before treatment. Five patients were classified as having the 'watermelon stomach' (group A) and three the 'honeycomb stomach' (group B), according to criteria described in previous reports. All were treated using neodymium:YAG laser photocoagulation. Significant endoscopic improvement and reduction in blood requirements were noticed in group A in which only one patient required a transfusion after treatment. Results in group B were disappointing. One patient was operated on and the other two still require blood transfusions. Laser treatment was safe in both groups and no major complications were encountered. (Gut 1994; 35: 461-463) The condition is often misdiagnosed as antral haemorrhagic gastritis.35' Biopsies confirm the correct diagnosis with the characteristic features of hyperplastic surface mucosa with dilated and thrombosed capillaries and fibromuscular hyperplasia of the lamina propria with ectatic submucosal venous channels.Although antrectomy offers definitive treatment of the condition, it carries significant short and longterm morbidity and an operative mortality of 5-10%.78 Conservative treatment with blood transfusion, iron replacement, histamine H2 receptor antagonists, sucralfate, steroids, tranexamic acid have all be applied with limited success, in an attempt to balance the blood loss, or to diminish the severity of the bleeding episodes.238 Endostasis has also been used with varying results."-'4 In this report we describe eight patients with DGAVE, treated with the Nd:YAG laser focusing on the different therapeutic response of these patients according to their endoscopic pattern.

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Section: Discussionmentioning

confidence: 58%

“…Patients were classified into two groups according to their endoscopic pattern using the criteria proposed by Chawla et al 4 Group A consisted of patients with the classic watermelon stomach and group B consisted of those patients with the honeycomb stomach (Fig 1).…”

Section: Patientsmentioning

confidence: 99%

Endoscopic laser treatment of diffuse gastric antral vascular ectasia.

Potamiano

Carter

Anderson

1994

Gut

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“…Chawla et al . have identified three macroscopic patterns 9 . The first and most common is the appearance described above as a ‘watermelon stomach’.…”

Section: Clinical Presentation and Diagnosismentioning

confidence: 99%

“…2 Chawla et al have identified three macroscopic patterns. 9 The first and most common is the appearance described above as a 'watermelon stomach'. The second most common appearance is a 'honeycomb stomach', characterized by the coalescence of many angiodysplastic lesions in the antrum.…”

Section: Clinical Presentation and Diagnosismentioning

confidence: 99%

Current therapeutic options for gastric antral vascular ectasia

Sebastian

O’Moráin

Buckley

2003

Aliment Pharmacol Ther

115

105

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Summary Gastric antral vascular ectasia, or ‘watermelon stomach’, is a rare but important cause of gastrointestinal blood loss and anaemia, which has characteristic endoscopic and histological features. The pathogenesis of this condition remains unclear; however, many associated disorders have been documented. Various medical, surgical and endoscopic therapeutic modalities have been attempted with variable success. Leading contenders for the therapeutic modality of choice include hormonal therapy, endoscopic Nd:YAG laser and argon plasma coagulation. Randomized controlled trials to identify the ideal treatment method are lacking at present.

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“…Gastric antral vascular ectasia (GAVE) is a disease of characteristic endoscopic finding of radiating patchy reddened mucosa resembling watermelon that was first described by Jabbari et al . 1 This disease is often recognized as a chronic medication-resistant hemorrhagic disease and is reported to be associated with several diseases, such as liver cirrhosis, [2][3][4][5][6][7][8][9] autoimmune disease 10 and renal failure. 11 Gastrointestinal hemorrhage is a very severe complication among patients with liver cirrhosis.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Coagulation Therapy Is Useful for Improving Encephalopathy in Cirrhotic Patients With Gastric Antral Vascular Ectasia

Zushi

Imai

Fukuda

et al. 2004

Digestive Endoscopy

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Background : Gastric antral vascular ectasia (GAVE) is an uncommon but treatable cause of chronic gastrointestinal bleeding often associated with severe cirrhosis. Efficacy of endoscopic treatment is well known; however, long-term outcome after endoscopic treatment is not clear. Methods : We studied 16 cases of GAVE patients with liver cirrhosis that were endoscopically treated using heater probe unit or argon plasma coagulator. Endoscopic finding of GAVE and clinical finding of hepatic encephalopathy in particular was evaluated after endoscopic therapy. Results : After endoscopic ablation therapy, mucosal vascular lesion of GAVE and rebleeding occurred in four patients during follow up; however, re-treatment was effective and long-term hemostasis was achieved. Moreover, a case report herein revealed the effectiveness of endoscopic therapy on hepatic encephalopathy of GAVE patients with cirrhosis. In the follow-up study of 13 patients of GAVE with cirrhosis that suffered from encephalopathy, the coma level of nine patients was improved after endoscopic therapy. Conclusion : Endoscopic treatment, such as heater probe coagulation and argon plasma coagulation therapy, are effective and useful for long-term follow up. Also, the beneficial effect of endoscopic therapy on hepatic encephalopathy for GAVE with cirrhosis encourages us to find and treat the mucosal lesion intensively to improve the quality of life of such patients.

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The honeycomb stomach: coalesced gastric angiodysplasia

Cited by 22 publications

References 18 publications

Endoscopic laser treatment of diffuse gastric antral vascular ectasia.

Endoscopic laser treatment of diffuse gastric antral vascular ectasia.

Current therapeutic options for gastric antral vascular ectasia

Endoscopic Coagulation Therapy Is Useful for Improving Encephalopathy in Cirrhotic Patients With Gastric Antral Vascular Ectasia

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