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GAVE (Watermelon stomach)

Tuesday 09 March 2010, Branislav Kunčak, M. D.

GAVE (gastric antral vascular ectasia)

  • Also called watermelon stomach
  • Rare disorder with pathogenesis that is not fully understood
  • Often accompanies other chronic diseases such as cirrhosis, chronic renal failure, heart failure, connective tissue disorders
  • More than 70% of patients with GAVE syndrome do not have cirrhosis or portal hypertension
  • Is a cause of acute or chronic GI bleeding
  • Endoscopic features: ectatic vessels along the longitudinal antral folds (image seen on endoscopy is pathognomic, in the majority of cases is diagnosis made endoscopically)
  • Histologic features (biopsy is helpful in unclear cases; it helps to distinguish GAVE and portal hypertensive gastropathy): capillary ectasia, microvascular thrombosis, fibromuscular hypertrophy of lamina propria
  • GAVE does not respond to therapy that decrease portal pressure (TIPS, beta-blockers)

Bigger image Endoscopy

Fig. 1

GAVE in a patient with cirrhosis due to NAFLD

Bigger image Endoscopy

Fig. 2

Keywords: GAVE, gastric antral vascular ectasia, watermelon stomach, GI bleeding, anemia