title: Successful treatment of refractory gastric antral vascular ectasia by distal gastrectomy: a case report.
abstract: 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.
authors.affiliation: Ting Jin, Wenzhou Medical University, Wenzhou 325016, Zhejiang Province, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Jin
authors.affiliation: Ting Jin, Wenzhou Medical University, Wenzhou 325016, Zhejiang Province, China.
authors.forename: Bao-Ying
authors.initials: BY
authors.lastname: Fei
authors.affiliation: Ting Jin, Wenzhou Medical University, Wenzhou 325016, Zhejiang Province, China.
authors.forename: Wei-Hua
authors.initials: WH
authors.lastname: Zheng
authors.affiliation: Ting Jin, Wenzhou Medical University, Wenzhou 325016, Zhejiang Province, China.
authors.forename: Yong-Xiang
authors.initials: YX
authors.lastname: Wang
mesh_terms: D000368:Aged; D057908:Argon Plasma Coagulation; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D005743:Gastrectomy; D020252:Gastric Antral Vascular Ectasia / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D005763:Gastroenterostomy; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D005773:Gastroscopy; D006439:Hemodynamics; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D008551:Melena / Q000209:etiology; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D006454:Hemoglobins
keywords: Argon plasma coagulation; Distal gastrectomy; Endoscopic band ligation; Gastric antral vascular ectasia; Melena