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Bleeding watermelon stomach treated by Nd-YAG laser photocoagulation
Endoscopy
|March 1, 1993
Summary
Diffuse antral vascular ectasia, or watermelon stomach, can cause significant bleeding in liver disease patients. Nd-YAG laser therapy effectively controlled bleeding in five patients, offering a safe and successful treatment option.
Area of Science:
- Gastroenterology
- Hepatology
- Endoscopic Therapy
Background:
- Diffuse antral vascular ectasia (watermelon stomach) is a rare cause of upper gastrointestinal bleeding.
- Patients with liver disease may present with bleeding from watermelon stomach, often misdiagnosed as hemorrhagic gastritis.
- Recurrent bleeding can necessitate blood transfusions and impact patient management.
Observation:
- Five patients with liver disease experienced recurrent bleeding from diffuse antral vascular ectasia.
- Initial misdiagnosis as hemorrhagic gastritis occurred in all cases.
- Standard medical treatment with antiulcer drugs was ineffective in controlling blood loss.
Findings:
- Neodymium-doped Yttrium Aluminum Garnet (Nd-YAG) laser therapy was employed to treat the gastric lesions.
- An average of 4 Nd-YAG laser sessions (range: 1-8) were administered.
- Endoscopic appearance improved, and bleeding was effectively controlled in all patients.
- A medium follow-up period of 8 months (range: 2-12 months) showed sustained hemostasis.
- No treatment-related complications were observed.
Implications:
- Nd-YAG laser therapy presents a viable and safe endoscopic treatment for watermelon stomach in patients with liver disease.
- Effective management of bleeding can prevent the need for transfusions and improve patient outcomes.
- Accurate diagnosis is crucial to guide appropriate therapeutic interventions for this condition.