GASTRIC ANTRAL VASCULAR ECTASIA (WATERMELON STOMACH) IN PATIENTS WITHSYSTEMIC-SCLEROSIS

This report describes 5 patients with systemic sclerosis (SSc) who dev eloped severe, recurrent upper gastrointestinal (GI) bleeding due to g astric antral vascular ectasia (GAVE), The clinical records, the endos copic findings, and the histologic appearance of biopsy specimens and surgically resected gastric tissue from the patients were reviewed. Al l 5 patients developed severe and recurrent episodes of upper GI bleed ing leading to severe anemia requiring multiple transfusions, The cuta neous involvement was diffuse in 3 patients and limited in 2, All but 1 had cutaneous telangiectasias. The diagnosis of GAVE was established by endoscopy within 3 years of the diagnosis of SSc in all cases, One patient required heater probe cautery, 2 required laser coagulation, and 2 underwent surgical resection of the gastric antrum for control o f the GI bleeding, The possibility of GAVE should be considered in SSc patients who have recurrent upper GI bleeding. It is suggested that t he antral vascular lesions in these patients may represent a component of the spectrum of vascular alterations of SSc.