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[Watermelon stomach and scleroderma].

Axel C P Diederichsen1, Jens Møller Rasmussen

  • 1Odense Universitetshospital, medicinsk afdeling C.

Ugeskrift for Laeger
|May 3, 2002
PubMed
Summary
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A 72-year-old man with watermelon stomach (gastric antral vascular ectasia) and scleroderma experienced severe anemia. Despite multiple endoscopic treatments, bleeding persisted, leading to significant transfusions and eventual death.

Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Rheumatology

Background:

  • Severe, persistent iron deficiency anemia can be a challenging clinical presentation.
  • Gastric antral vascular ectasia, or watermelon stomach, is a potential cause of gastrointestinal bleeding.
  • Scleroderma is a systemic autoimmune disease that can affect various organs.

Observation:

  • A 72-year-old male presented with severe iron deficiency anemia.
  • Endoscopy revealed characteristic watermelon stomach (gastric antral vascular ectasia).
  • The patient had scleroderma with calcinosis, sclerodactyly, and telangiectasias, but no Raynaud's phenomenon or esophageal dysmotility.

Findings:

  • Argon laser therapy, repeated six times, failed to control the gastric bleeding.

Related Experiment Videos

  • The patient required 62 units of blood transfusions over nine months.
  • The patient ultimately died from complications related to the persistent bleeding.

    • Implications:

    • This case highlights the potential severity and refractoriness of gastric antral vascular ectasia in patients with connective tissue diseases like scleroderma.
    • It underscores the limitations of endoscopic therapy in managing severe, persistent gastrointestinal bleeding from this condition.
    • Aggressive management and consideration of alternative therapies may be necessary for refractory cases.