An Analysis of the Clinical, Laboratory, and Histological Features of Striped, Punctate, and Nodular Gastric Antral Vascular Ectasia
| Autor: | William Marsteller, David N. Lewin, Arul M. Thomas, Adrian Reuben, David G. Koch |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Gastrointestinal bleeding Cirrhosis Physiology Gastroenterology Severity of Illness Index 03 medical and health sciences Liver disease 0302 clinical medicine Internal medicine Ectasia Gastroscopy medicine Humans Aged Retrospective Studies medicine.diagnostic_test business.industry Platelet Count Stomach Patient Selection Gastric antral vascular ectasia Middle Aged medicine.disease Endoscopy medicine.anatomical_structure Gastric Mucosa 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Histopathology Female business Gastric Antral Vascular Ectasia |
| Zdroj: | Digestive diseases and sciences. 63(4) |
| ISSN: | 1573-2568 |
| Popis: | Gastric antral vascular ectasia (GAVE) commonly presents as linear striped (“watermelon stomach”) or punctate phenotypes, to which a newly discovered nodular form was recently added. We performed a retrospective cohort study to detail and compare the clinical and histological characteristics of major GAVE phenotypes. In 136 GAVE patients (tertiary care ambulatory and inpatient, median age 61.3 years, 73 men, and 63 women), clinical and laboratory results were recorded, with comorbidities, endoscopy indications, and complications of cirrhosis. In 74 patients, GAVE histopathology was cataloged by a pathologist masked to endoscopy results. Median age 61.3 years, 73 men, and 63 women. GAVE phenotypes were: linear striped—62 (46%), punctate—32 (24%), and nodular—41 (30%). Endoscopy was commonly performed for variceal screening in linear striped (45%) and nodular (34%) GAVE and for gastrointestinal bleeding in punctate (41%) and nodular (29%) GAVE, respectively. Of 89 cirrhotic patients, 37.5% each had linear striped or nodular GAVE, 24.7% had punctate forms (p = 0.03). Child–Turcotte–Pugh and Model for End-Stage Liver Disease scores were similar among phenotypes. Histologically, reactive epithelial hyperplasia and vascular ectasia were universal; smooth muscle proliferation was more common and consistent (78–86%) than microvascular thrombi (27–59%) and fibrohyalinosis (18–53%), which each varied with phenotype. Nodular GAVE is a gastric mucosal abnormality that is similar to the linear striped and punctate phenotypes, yet has distinct clinical and histological features. Increased awareness of nodular GAVE by endoscopists is needed to avoid its misdiagnosis as nonspecific antral nodules. |
| Databáze: | OpenAIRE |
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