Treatment of watermelon stomach (GAVE syndrome) by means of endoscopic argon plasma coagulation (APC): Long-term outcome

We report on 17 patients with GAVE-syndrome (gastric antral vascular ectasi a) treated by means of endoscopic argon plasma coagulation (APC), 16 of 17 patients presented with iron deficiency anemia; transfusion-dependent anemi a was noted in 11 patients (65%). Resolution of the gastric angiectasia cou ld be achieved in all patients by endoscopic APC after 1-4 treatment sessio ns. Endoscopic follow-up revealed recurrence of GAVE in 5 patients (requiri ng further treatment sessions), Mean pretreatment hemoglobin level of 78 g/ l improved to 115 g/l after treatment. Only one patient needed post-treatme nt transfusions; she had refused further endoscopy, The mean follow-up was 30.4 months (range 1-65). In one case circumferential starring of the antrum led to asymptomatic sten osis 6 months after APC; at the same time early recurrence of extensive ang iectasia occurred. Billroth resection was performed. No other complications were observed. Our results show that argon plasma coagulation is an effective and safe tre atment for gastrointestinal blood loss due to GAVE syndrome (watermelon sto mach). Control endoscopies are indicated in order to recognize and treat re currence of angiectasia on time.