ENDOSCOPIC LASER THERAPY FOR WATERMELON STOMACH

Eleven patients (nine females, two males) with anaemia due to acute an d chronic gastrointestinal blood loss were found to have gastric antra l vascular ectasia (watermelon stomach). Nine patients were transfusio n-dependent, receiving a mean of 13.1 units over a mean period of 12.3 months. All patients received neodymium:yttrium-aluminium-garnet lase r coagulation with a median of 3.0 treatment sessions. Post-treatment transfusion needs were abolished in six patients and minimal in two pa tients during a mean follow up of 27.3 months (range 12-60 months). Ov erall there was a mean reduction in transfusion requirement with treat ment from 2.5 units per month to 0.4 units per month (P < 0.02). Mean pretreatment haemoglobin improved from 7.7 to 11.9 g/dL after treatmen t (P < 0.001). No complications occurred. Laser coagulation is safe an d effective treatment for anaemia due to watermelon stomach and should be considered as first line therapy.