GASTRIC ANTRAL VASCULAR ECTASIA SUCCESSFULLY TREATED BY ENDOSCOPIC ELECTROCOAGULATION

We report two cirrhotic patients with gastric antral vascular ectasia (GAVE) in whom chronic blood loss presented a major problem. Case 1, a 69-year-old man, had alcoholic liver cirrhosis. and case 21 a 75-year -old woman, had liver cirrhosis associated with hepatitis C virus. The patients required repeated blood transfusions but still exhibited per sistent anemia. On upper gastrointestinal endoscopy, both patients sho wed esophageal varices without stigmata of bleeding or red color signs and presented with a characteristic antral appearance so distinctive as to be diagnostic; diffuse erythemas consisting of ectatic and tortu ous capillaries throughout the antrum. Endoscopic electrocoagulation t reatment with a monopolar probe was effective for controlling blood lo ss from GAVE. The patients tolerated the procedure well and there were no resultant complications. Several sessions of the treatment resulte d in eradication of almost all the vascular lesions, negative fecal oc cult blood test results, and marked alleviation of their anemia withou t further treatment. Endoscopic electrocoagulation is suggested to be a safe, non-invasive, and effective treatment for blood loss from GAVE , especially in patients with liver cirrhosis in whom surgery carries an increased risk.