Other nonneoplastic

Gastric antral vascular ectasia

Topic Completed: 1 July 2012

Minor changes: 23 April 2021

Copyright: 2003-2021,, Inc.

PubMed Search: gastric antral vascular ectasia

Elliot Weisenberg, M.D.
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Page views in 2021 to date: 5,521
Cite this page: Weisenberg E. Gastric antral vascular ectasia. website. Accessed November 29th, 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)
  • 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
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