Successful Surgical Management of Gastric Antral Vascular Ectasia in a Patient with End-Stage Renal Disease: A Case Report and Literature Review

BACKGROUND Gastric antral vascular ectasia (GAVE) is a rare clinical entity that presents with acute upper-gastrointestinal bleeding or chronic anemia. It is characterized by endoscopic watermelon appearance of the stomach. It is usually associated with other comorbidities; however, few articles hav...

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Bibliographic Details
Published in:	The American journal of case reports Vol. 24; p. e938543
Main Authors:	Alsaeed, Bader H, AlAbdulqader, Ayesha A, Al-Qadhi, Ali A, Alaswad, Hawra A, Foula, Mohammed S, Alshomimi, Saeed J
Format:	Journal Article
Language:	English
Published:	United States International Scientific Literature, Inc 13-03-2023
Subjects:	Anemia - etiology Female Gastric Antral Vascular Ectasia - complications Gastric Antral Vascular Ectasia - surgery Gastrointestinal Hemorrhage - etiology Humans Kidney Failure, Chronic - therapy Middle Aged Renal Dialysis - adverse effects
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Summary:	BACKGROUND Gastric antral vascular ectasia (GAVE) is a rare clinical entity that presents with acute upper-gastrointestinal bleeding or chronic anemia. It is characterized by endoscopic watermelon appearance of the stomach. It is usually associated with other comorbidities; however, few articles have previously described GAVE in patients with end-stage renal disease. Its management is controversial, and endoscopic management is considered the treatment of choice. CASE REPORT A middle-age female patient, on regular hemodialysis for ESRD, was referred to the surgical out-patient clinic as a refractory GAVE after failure of endoscopic management as she became blood transfusion-dependent. She underwent laparoscopic subtotal gastrectomy with a Billroth II reconstruction of gastrojejunostomy. She had a smooth postoperative course and was followed up in the clinic for 12 months with no complications. Her hemoglobin level was stable at 9.4 g/dL without further blood transfusion. CONCLUSIONS Gastric antral vascular ectasia is usually associated with other comorbidities; however, an association between GAVE and CKD is rare. Its management is controversial, and endoscopic management is considered the preferred method of treatment. Laparoscopic subtotal gastrectomy is an effective management modality for GAVE, with dramatic improvement and good outcomes in terms of bleeding, blood transfusion requirements, and nutritional status.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Review-3 content type line 23 ObjectType-Feature-5 ObjectType-Article-4 ObjectType-Report-1 Funds Collection Authors’ Contribution Conflict of interest: None declared Data Interpretation Financial support: None declared Literature Search Data Collection Study Design Manuscript Preparation Statistical Analysis
ISSN:	1941-5923 1941-5923
DOI:	10.12659/AJCR.938543