Abstract
Background: Gastric antral vascular ectasia (GAVE) is an uncommon but often severe cause of upper gastrointestinal (GI) bleeding, responsible for about 4% of non‐variceal upper GI hemorrhage. The diagnosis is mainly based on endoscopic pattern and, for uncertain cases, on histology. Medical therapy has not clearly shown satisfactory results and surgery should only be considered for refractory severe cases. Endoscopic therapy, particularly treatment with Argon Plasma Coagulation (APC), has shown to be as effective and also safer than surgery, and should be considered the first line treatment for patients with GAVE‐related bleeding.
Aim: We aim to analyze the efficacy and safety of APC in the treatment of GAVE in our center.
Methods: We retrospectively collected data of GAVE patients underwent APC in Gastrointestinal Endoscopy Center, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia, from January 2017 until June 2019.
Results: A total of 4 patients underwent APC in the treatment of GAVE were included in this study. All patients in this study were identified as geriatric patients. There were comorbidities of GAVE patients with cirrhosis, and chronic kidney disease. All patients diagnosed with GAVE have chief complaint of having black tarry stool. Response to APC was assessed by decreasing frequency and severity of upper gastrointestinal bleeding or improvement of hemoglobin level in all patients. All visible lesions were targeted at each session and follow‐up procedures were arranged in four‐week intervals to allow the lesion to heal. No major complications, such as perforation and explosion occurred after APC procedure in GAVE patients.
Conclusion: APC for the treatment of GAVE could be an effective and safe therapeutic modality.
Aim: We aim to analyze the efficacy and safety of APC in the treatment of GAVE in our center.
Methods: We retrospectively collected data of GAVE patients underwent APC in Gastrointestinal Endoscopy Center, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia, from January 2017 until June 2019.
Results: A total of 4 patients underwent APC in the treatment of GAVE were included in this study. All patients in this study were identified as geriatric patients. There were comorbidities of GAVE patients with cirrhosis, and chronic kidney disease. All patients diagnosed with GAVE have chief complaint of having black tarry stool. Response to APC was assessed by decreasing frequency and severity of upper gastrointestinal bleeding or improvement of hemoglobin level in all patients. All visible lesions were targeted at each session and follow‐up procedures were arranged in four‐week intervals to allow the lesion to heal. No major complications, such as perforation and explosion occurred after APC procedure in GAVE patients.
Conclusion: APC for the treatment of GAVE could be an effective and safe therapeutic modality.
Original language | English |
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Pages | 583-853 |
DOIs | |
Publication status | Published - 11 Nov 2019 |