Endoscopic treatment outcomes in watermelon stomach patients with and without portal hypertension.
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Dulai
G S
GS
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. gdulai@mednet.ucla.edu
Jensen
D M
DM
Kovacs
T O G
TO
Gralnek
I M
IM
Jutabha
R
R
D000368:Aged; D015331:Cohort Studies; D005260:Female; D020252:Gastric Antral Vascular Ectasia / Q000150:complications / Q000473:pathology / Q000628:therapy*; D006471:Gastrointestinal Hemorrhage / Q000517:prevention & control; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000628:therapy*; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome