TRANEXAMIC ACID FOR SEVERE BLEEDING GASTRIC ANTRAL VASCULAR ECTASIA IN CIRRHOSIS

Background-It is believed that severe portal hypertensive gastropathy probably accounts for most non-variceal bleeding episodes in patients with cirrhosis. Gastric antral vascular ectasia (GAVE) also occurs in these patients. It is not clear whether it is a variant of portal hype rtensive gastropathy or a distinct condition. Patient-A patient, a 66 year od woman, with cirrhosis initially diagnosed as having portal hyp ertensive gastropathy and subsequently classified as GAVE is described . She required transfusion with a total of 130 units of packed red cel ls for gastrointestinal blood loss. Results-The bleeding did not respo nd to portal decompression with TIPS or beta blockers. Following treat ment with oral tranexamic acid she has not required further blood tran sfusion over a period of 30 months. Conclusion-Tranexamic acid may be a useful treatment for refractory bleeding due to gastric antral vascu lar ectasia in patients with cirrhosis.