Gastric vascular ectasia is an uncommon etiology of gastrointestinal (GI) bleeding.
Gastric vascular ectasia can affect not only patients with cirrhosis but also patients with a variety of chronic diseases.
Dr Stéphane Lecleire and colleagues from France compared clinical and endoscopic patient characteristics and responses to treatment by argon plasma coagulation of bleeding gastric vascular ectasia between patients with cirrhosis and noncirrhotic patients.
|Endoscopy revealed a "watermelon" appearance in 77% of patients with cirrhosis|
The research team treated 30 patients by argon plasma coagulation for bleeding gastric vascular ectasia between 2001 and 2005.
Clinical and endoscopic features and argon plasma coagulation treatment success were compared between patients with cirrhosis and noncirrhotic patients.
Endoscopic treatment efficacy was assessed on the recurrence of symptoms after argon plasma coagulation.
The researchers noted that 17 patients were cirrhotic, and 13 had no cirrhosis.
Cirrhotic patients presented more frequently with overt bleeding, and noncirrhotic patients with occult bleeding with iron deficiency anemia.
The team found that endoscopy revealed a "watermelon" appearance in 24% of noncirrhotic patients vs 77% in patients with cirrhosis.
Endoscopic treatment by argon plasma coagulation was successful in 83% of patients.
Patients without cirrhosis required significantly more argon plasma coagulation sessions to achieve a complete treatment.
Dr Lecleire's team concluded, "Argon plasma coagulation treatment of bleeding gastric vascular ectasia was efficient and safe in cirrhotic and noncirrhotic patients in more than 80% of cases."
"Noncirrhotic patients required significantly more argon plasma coagulation sessions to achieve a complete treatment."
"An endoscopic watermelon appearance and the use of antiplatelet drugs were associated with failure of argon plasma coagulation."