Gastric antrai vascular ectasia and end-stage renal disease: literature review

Straipsnio įrankiai
Sek, 2017/11/19 - 18:08
Laboratorinė medicina. 2017,
t. 19,
Nr. 3,
p. 195 -
201
Autoriai: 
Evelina Sestelinska, Julius Lavinskas, Laurynas Rimševičius

Background. Gastric antrai vascular ectasia is currently recognized as an important cause of upper gastrointestinal hemorrhage and has a high prevalence in patients with renal insufficiency and end-stage renal dis­ease. It is responsible for about 4% of non-variceal upper gastrointesti­nal hemorrhages and typically presents in middle aged females. GAVE, also called “watermelon stomach”, is diagnosed through esophagogastroduodenoscopy and is characterized by the presence of visible columns of red tortuous enlarged vessels along the longitudinal folds of the antrum. The pathogenesis is still obscure and many hypotheses have been proposed such as mechanical stress, humoral and autoimmune factors. In the last two decades, numerous therapeutic strategies have been proposed, including surgical, endoscopic, and medical choices, yet successful treatment of GAVE continues to be a challenge. Currently, given the rapid response, safety, and efficacy, endoscopic ablative modalities have largely usurped medical treatments as first-line therapy, particularly using argon plasma coagulation.

Conclusions. GAVE syndrome is a serious condition and has a higher prevalence in end-stage renal disease patients, especially in those presenting with treatment-refractory anemia. Realization of its etiology and characteristics is essential for doctors to suspect, diagnose, and treat gastric ectasia. Only proper diagnosis and well-timed disease treatment can significantly improve patient's medical condition and future prognosis.

© 2018, Lietuvos laboratorinės medicinos draugija