Stomach
Other nonneoplastic
Gastric antral vascular ectasia
Author: Elliot Weisenberg, M.D.
Topic Completed: 1 July 2012
Minor changes: 1 September 2020
Copyright: 2003-2021, PathologyOutlines.com, Inc.
PubMed Search: gastric antral vascular ectasia
Table of Contents
Definition / general | Treatment | Microscopic (histologic) description | Differential diagnosisCite this page: Weisenberg E. Gastric antral vascular ectasia. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/stomachantralvascularect.html. Accessed March 4th, 2021.
Definition / general
- 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
- Endoscopy: parallel red stripes (hyperemic streaks) at antral mucosal folds resemble watermelon stripes (Endoscopy 2004;36:640)
Treatment
- Iron supplementation in mild cases
- Argon laser photocoagulation or antrectomy in severe cases
Microscopic (histologic) description
- 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
Differential diagnosis
- Dieulafoy's lesion / caliber persistent artery of stomach: large diameter artery in gastric submucosa that compresses mucosa, causing erosion, bleeding from artery; 60% mortality
- Portal hypertension: causes vascular ectasia with different endoscopic appearance, no acute erosions, no fibrin thrombi
