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The watermelon rectum.

D Singh¹, M Shill, H Kaur

¹Department of Internal Medicine, Akron General Medical Center, Akron, Ohio 44307, USA.

Journal of Clinical Gastroenterology

|July 27, 2001

Summary

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This study reports the first case of rectal vascular ectasia linked to gastric antral vascular ectasia (watermelon stomach) in a patient with systemic sclerosis. This finding suggests a potential new gastrointestinal manifestation of systemic sclerosis.

Area of Science:

Gastroenterology
Vascular Medicine
Rheumatology

Background:

Systemic sclerosis is a connective tissue disease known to cause gastrointestinal dysmotility.
Gastric antral vascular ectasia (GAVE), or watermelon stomach, is a recognized gastrointestinal complication of systemic sclerosis.

Observation:

A 39-year-old woman with systemic sclerosis presented with chronic gastrointestinal bleeding and anemia.
Endoscopy revealed characteristic watermelon-like vascular stripes in the gastric antrum and rectum.
Histology confirmed dilated, thrombosed capillaries in the gastric and rectal lamina propria.

Findings:

This is the first reported case of rectal vascular ectasia co-occurring with gastric antral vascular ectasia.
The patient exhibited other gastrointestinal issues including esophageal aperistalsis, reflux, and small intestine dysmotility.

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Successful treatment was achieved with endoscopic bipolar electrocautery.

Implications:

Rectal vascular ectasia may represent an additional gastrointestinal manifestation of systemic sclerosis.
This finding expands the understanding of vascular complications in systemic sclerosis.
Further research is warranted to explore the prevalence and pathophysiology of rectal vascular ectasia in systemic sclerosis patients.