Cure of gastric antral vascular ectasia by liver transplantation despite persistent portal hypertension: a clue for pathogenesis.
Gastric antral vascular ectasia (GAVE) is a rare cause of chronic bleeding in cirrhotic patients. It has been suggested that these gastric lesions might be related to portal hypertension, hepatic insufficiency, or both parameters. We report two cases of cirrhotic patients in whom GAVE was the source of recurrent bleeding. These patients also had complete portal vein thrombosis. Liver transplantation was performed and an end-to-end cavoportal anastomosis was performed, leaving patients with persistent portal hypertension after surgery. We observed complete disappearance of the antral lesions several weeks after transplantation, which shows that the GAVE is not related to portal hypertension but is rather a direct consequence of liver failure. Possible pathophysiologic mechanisms are discussed.
Vincent
Catherine
C
Liver Unit, Hôpital Saint-Luc, Hôpital du Saint-Sacrement and Université Laval, Québec, Canada.
Pomier-Layrargues
Gilles
G
Dagenais
Michel
M
Lapointe
Réal
R
Létourneau
Richard
R
Roy
André
A
Paré
Pierre
P
Huet
P Michel
PM
D005260:Female; D020252:Gastric Antral Vascular Ectasia / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome