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Diagnosis and management of gastric antral vascular ectasia 被引量:11
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作者 Lorenzo Fuccio Alessandro Mussetto +2 位作者 Liboria Laterza Leonardo Henry Eusebi Franco Bazzoli 《World Journal of Gastrointestinal Endoscopy》 CAS 2013年第1期6-13,共8页
Gastric antral vascular ectasia (GAVE) is an uncommon but often severe cause of upper gastrointestinal (GI) bleeding, responsible of about 4% of non-variceal upper GI haemorrhage. The diagnosis is mainly based on endo... Gastric antral vascular ectasia (GAVE) is an uncommon but often severe cause of upper gastrointestinal (GI) bleeding, responsible of about 4% of non-variceal upper GI haemorrhage. The diagnosis is mainly based on endoscopic pattern and, for uncertain cases, on histology. GAVE is characterized by a pathognomonic endoscopic pattern, mainly represented by red spots either organized in stripes radially departing from pylorus, defined as watermelon stomach, or arranged in a diffused-way, the so called honeycomb stomach. The histological pattern, although not pathognomonic, is characterized by four alterations:vascular ectasia of mucosal capillaries, focal thrombosis, spindle cell proliferation and fibrohyalinosis, which consist of homogeneous substance around the ectatic capillaries of the lamina propria. The main differential diagnosis is with Portal Hypertensive Gastropathy, that can frequently co-exists, since about 30% of patients with GAVE co-present a liver cirrhosis. Autoimmune disorders, mainly represented by Reynaud's phenomenon and sclerodactyly, are co-present in about 60% of patients with GAVE; other autoimmune and connective tissue disorders are occasionally reported such as Sjogren's syndrome, systemic lupus erythematosus, primary biliary cirrhosis and systemic sclerosis. In the remaining cases, GAVE syndrome has been described in patients with chronic renal failure, bone marrow transplantation and cardiac diseases. The pathogenesis of GAVE is still obscure and many hypotheses have been proposed such as mechanical stress, humoural and autoimmune factors and hemodynamic alterations. In the last two decades, many therapeutic options have been proposed including surgical, endoscopic and medical choices. Medical therapy has not clearly shown satisfactory results and surgery should only be considered for refractory severe cases, since this approach has significant mortality and morbidity risks, especially in the setting of portal hypertension and liver cirrhosis. Endoscopic therapy, particularly treatment with Argon Plasma Coagulation, has shown to be as effective and also safer than surgery, and should be considered the first-line treatment for patients with GAVE-related bleeding. 展开更多
关键词 Gastric antral vascular ECTASIA BLEEDING watermelon stomach ARGON plasma COAGULATION
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胃窦毛细血管扩张症“西瓜胃”1例并文献复习
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作者 岳静茹 李忠霞 张姮 《江汉大学学报(自然科学版)》 2022年第2期69-75,共7页
目的胃窦毛细血管扩张症(gastric antral vascular ectasia,GAVE)是一种罕见但重要的上消化道出血性疾病,本研究旨在提高临床医生对该病的鉴别和诊治水平。方法对收治的1例GAVE患者临床资料进行分析,并结合现有文献资料对GAVE的病因、... 目的胃窦毛细血管扩张症(gastric antral vascular ectasia,GAVE)是一种罕见但重要的上消化道出血性疾病,本研究旨在提高临床医生对该病的鉴别和诊治水平。方法对收治的1例GAVE患者临床资料进行分析,并结合现有文献资料对GAVE的病因、发病机制、诊治方法进行回顾性综述。结果老年女性患者,表现为中重度贫血,需反复输血治疗,胃镜下可见典型的“西瓜胃”样表现。结论氩离子凝固术(argon plasma coagulation,APC)是目前治疗GAVE应用最广泛的临床手段,操作简便、成本较低、安全性高,但往往需多次治疗才能达到临床治愈。 展开更多
关键词 胃窦毛细血管扩张症 西瓜胃 消化道出血 内镜治疗
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肝硬化失代偿期并胃窦血管扩张症1例
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作者 刘晓波 高子夜 +3 位作者 潘俊 杨志豪 金曙 李胜保 《安徽医药》 CAS 2022年第5期1027-1030,共4页
目的探讨胃窦血管扩张综合征(GAVE)临床表现、内镜特征、诊治要点,提高对GAVE的认识,减少误诊。方法回顾性分析十堰市太和医院1例误诊GAVE病人临床表现、内镜、实验室检查结果及治疗过程,并行文献回顾。结果病人66岁,男,肝硬化失代偿期... 目的探讨胃窦血管扩张综合征(GAVE)临床表现、内镜特征、诊治要点,提高对GAVE的认识,减少误诊。方法回顾性分析十堰市太和医院1例误诊GAVE病人临床表现、内镜、实验室检查结果及治疗过程,并行文献回顾。结果病人66岁,男,肝硬化失代偿期,临床表现为长期贫血、反复黑便,检查胃镜提示胃窦可见散在糜烂及出血点,病情活动时可见多处点状渗血灶,病人误诊为门脉高压性胃病,行抑酸、降门脉压、输血及止血等治疗,并行经颈静脉肝内门体分流术(TIPS)治疗,最终死于多器官功能衰竭。结合病人病史及多次内镜检查结果,诊断考虑为GAVE。结论GAVE发病率低,易误诊,病史及内镜检查是诊断的重要依据,确诊需要结合病理检查,内镜治疗是重要措施,TIPS治疗可能无效,外科手术是重要治疗手段。 展开更多
关键词 胃窦血管扩张 西瓜胃 肝硬化失代偿期 内镜 误诊
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Anaemia in a Patient with Diffuse Systemic Scleroderma
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作者 Karan Grover Rohit Peshin 《International Journal of Clinical Medicine》 2013年第7期319-320,共2页
We hereby present a case of anaemia in a 73 years old patient with known past medical history of diffuse systemic scleroderma, who presented with acute onset of dizziness and haemetemesis. Blood tests revealed sudden ... We hereby present a case of anaemia in a 73 years old patient with known past medical history of diffuse systemic scleroderma, who presented with acute onset of dizziness and haemetemesis. Blood tests revealed sudden drop of haemoglobin and an urgent gastroscopy revealed gastric antral vascular ectasia (GAVE) or “watermelon stomach”. GAVE is a rare but well recognised cause of acute bleeding in systemic scleroderma patients and should be kept as a differential diagnosis in the work up of anaemia in these patients. 展开更多
关键词 SCLERODERMA Gastric Antral Vascular ECTASIA watermelon stomach
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