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Watermelon stomach following and preceding systemic sclerosis
O Elkayam1, M Oumanski, M Yaron
1Department of Rheumatology, Tel Aviv Medicine, University of Tel Aviv, Israel.
Seminars in Arthritis and Rheumatism
|November 9, 2000
Summary
Watermelon stomach, a rare cause of bleeding in systemic sclerosis (SSc), presents as gastric antral vascular ectasia. Early recognition and treatments like Nd-Yag laser therapy can improve outcomes for SSc patients.
Area of Science:
- Gastroenterology
- Rheumatology
- Vascular Medicine
Background:
- Systemic sclerosis (SSc) is a multisystem autoimmune disease characterized by fibrosis and vascular abnormalities.
- Gastric antral vascular ectasia, also known as watermelon stomach, is a recognized but uncommon cause of upper gastrointestinal bleeding.
Observation:
- This report details two patients with watermelon stomach associated with SSc, presenting with microcytic hypochromic anemia.
- Esophagogastroscopy revealed characteristic vascular malformations in the gastric antrum.
- Literature review identified 16 cases of watermelon stomach in SSc patients, predominantly women, often accompanied by other autoimmune conditions.
Findings:
- Both patients responded favorably to Nd-Yag laser therapy, with resolution of vascular lesions and improvement in anemia.
- In the literature, transendoscopic treatments were successful in most cases, while some required surgery.
- Watermelon stomach can precede, coincide with, or follow the diagnosis of SSc.
Implications:
- Watermelon stomach should be considered in SSc patients experiencing unexplained gastrointestinal bleeding.
- Increased awareness of this association can lead to earlier diagnosis and effective management.
- Timely intervention can alleviate anemia and reduce the need for blood transfusions or surgical procedures.