Stomach - Gastric Antral Vascular Ectasia (GAVE)

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Stomach

Other non-neoplastic lesions

Gastric Antral Vascular Ectasia (GAVE)

Reviewers: Elliot Weisenberg, M.D. (see Reviewers page)
Revised: 4 August 2012, last major update July 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● Also called watermelon stomach
● Rare acquired vascular disease that may cause blood loss and iron deficiency anemia due to chronic antral hemorrhage
● Associated with connective tissue diseases, particularly systemic sclerosis, but etiology unclear (Arch Pathol Lab Med 2002;126:375)
● 70% occur in elderly women

Treatment
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● Iron supplementation in mild cases
● Argon laser photocoagulation or antrectomy in severe cases

Endoscopy description
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● Parallel red stripes (hyperemic streaks) at antral mucosal folds resemble watermelon stripes (Endoscopy 2004;36:640)

Endoscopy images
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Various images

Micro description
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● Minimal changes
● Increase in blood vessel number and diameter with fibrin thrombi, fibromuscular hyperplasia (Am J Surg Pathol 1987;11:750)
● Reactive foveolar epithelial changes, resembles reactive gastropathy

Micro images
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Various images

Differential diagnosis
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● Portal hypertension: causes vascular ectasia with different endoscopic appearance, no acute erosions, no fibrin thrombi
● Dieulafoy’s lesion / caliber persistent artery of stomach: large diameter artery in gastric submucosa that compresses mucosa, causing erosion, bleeding from artery; 60% mortality

End of Stomach > Other non-neoplastic lesions > Gastric Antral Vascular Ectasia (GAVE)

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