Images in Clinical Medicine
Vascular Ectasia of the Gastric Antrum
N Engl J Med 1998; 339:166July 16, 1998
- Article
Figure 1 A 76-year-old woman presented with a two-month history of intermittent melena, weakness, and anemia that required the transfusion of six units of packed red cells. In the past she had been treated for hypertension and hypothyroidism. Esophagogastroduodenoscopy revealed gastric atrophy and bright red stripes in the antrum of the stomach that radiated spokelike from the pylorus and resembled the stripes of a watermelon — the typical findings of vascular ectasia of the gastric antrum. In Panel A, the view from the distal portion of the gastric body shows a linear pattern of vascular ectasias that begin in the antrum. Panels B and C show the close-up appearance of the vascular ectasias (the arrow in Panel C indicates the pylorus). The patient underwent three sessions of endoscopic laser coagulation under sedation with meperidine and midazolam, each lasting 20 to 30 minutes, over the course of eight weeks. At the time of the last follow-up one year after the final laser session, she felt well, although her stools were intermittently positive for occult blood. Her hemoglobin level was 11.4 g per deciliter, and she had not required any further blood transfusions.
Jeffrey L. Barnett, M.D.
University of Michigan Hospitals, Ann Arbor, MI 48109-0362
