Gastric Antral Vascular Ectasia
Argon Plasma Coagulation
Pyloric Antrum
Argon
Gastrointestinal Hemorrhage
Dilatation, Pathologic
Light Coagulation
Angiodysplasia
Hemostasis, Endoscopic
Endoscopy, Gastrointestinal
Raynaud Disease
Scleroderma, Localized
Pruritus
Scleroderma, Systemic
CREST Syndrome
Scleroderma, Diffuse
Gastric antral vascular ectasia in cirrhotic patients: absence of relation with portal hypertension. (1/22)
BACKGROUND: Portal hypertensive gastropathy and gastric antral vascular ectasia (GAVE) are increasingly recognised as separate entities. The pathogenic role of portal hypertension for the development of GAVE is still controversial. AIMS: To evaluate the effects of portal decompression on chronic bleeding related to GAVE in cirrhotic patients. METHODS: Eight patients with cirrhosis and chronic blood loss related to GAVE were included. GAVE was defined endoscopically and histologically. RESULTS: All patients had severe portal hypertension (mean portocaval gradient (PCG) 26 mm Hg) and chronic low grade bleeding. Seven patients underwent transjugular intrahepatic portosystemic shunt (TIPS) and one had an end to side portacaval shunt. Rebleeding occurred in seven patients. In these, TIPS was found to be occluded after 15 days in one patient; in the other six, the shunt was patent and the PCG was below 12 mm Hg in five. In the responder, PCG was 16 mm Hg. Antrectomy was performed in four non-responders; surgery was uneventful, and they did not rebleed after surgery, but two died 11 and 30 days postoperatively from multiorgan failure. In one patient, TIPS did not control GAVE related bleeding despite a notable decrease in PCG. This patient underwent liver transplantation 14 months after TIPS; two months after transplantation, bleeding had stopped and the endoscopic appearance of the antrum had normalised. CONCLUSIONS: Results suggest that GAVE is not directly related to portal hypertension, but is influenced by the presence of liver dysfunction. Antrectomy is a therapeutic option when chronic bleeding becomes a significant problem but carries a risk of postoperative mortality. (+info)The efficacy of octreotide therapy in chronic bleeding due to vascular abnormalities of the gastrointestinal tract. (2/22)
BACKGROUND: The treatment of angiodysplasia and watermelon stomach, vascular abnormalities implicated in gastrointestinal bleeding of obscure origin, is a major clinical problem. AIM: To determine the efficacy of octreotide in patients with long-standing gastrointestinal bleeding due to acquired angiodysplasia and watermelon stomach, resistant to previous treatments and not suitable for surgery because of old age and/or concomitant disorders. PATIENTS AND METHODS: We treated 17 patients (seven had isolated angiodysplasia, seven had multiple upper and lower gastrointestinal angiodysplasia, and three had watermelon stomach) with octreotide (0. 1 mg subcutaneous t.d.s. for 6 months). Six of the patients had liver cirrhosis, one had Glanzmann-type platelet derangement, two had cardiovascular diseases and one had chronic uraemia. RESULTS: Octreotide treatment stopped bleeding in 10 patients. A transient improvement was observed in four, who needed subsequent cyclical retreatment to correct low haemoglobin levels. No effect was observed in three, probably due to the severity of the concomitant disorders. CONCLUSIONS: Octreotide is a safe drug that may be useful to control the recurrent gastrointestinal bleeding due to acquired angiodysplasia and watermelon stomach, especially in patients who are not candidates for surgery due to old age and/or concomitant disorders. (+info)Gastric antral vascular ectasia in systemic sclerosis: complete resolution with methylprednisolone and cyclophosphamide. (3/22)
A case of severe, transfusion dependent anaemia in a 72 year old woman, which on endoscopy was found to be due to gastric antral vascular ectasia (GAVE), is reported. Repeated endoscopic sclerotherapy was ineffective. She subsequently developed Raynaud's phenomenon and on further investigation was found to have classical systemic sclerosis with lung involvement. Treatment with pulses of intravenous methylprednisolone and cyclophosphamide resulted in significant improvement in her pulmonary function tests and skin score. Coincidentally, her haemoglobin stabilised and further endoscopic examinations were normal. This is the first report of cyclophosphamide and methylprednisolone leading to complete and sustained resolution of GAVE in association with systemic sclerosis. (+info)Cure of gastric antral vascular ectasia by liver transplantation despite persistent portal hypertension: a clue for pathogenesis. (4/22)
Gastric antral vascular ectasia (GAVE) is a rare cause of chronic bleeding in cirrhotic patients. It has been suggested that these gastric lesions might be related to portal hypertension, hepatic insufficiency, or both parameters. We report two cases of cirrhotic patients in whom GAVE was the source of recurrent bleeding. These patients also had complete portal vein thrombosis. Liver transplantation was performed and an end-to-end cavoportal anastomosis was performed, leaving patients with persistent portal hypertension after surgery. We observed complete disappearance of the antral lesions several weeks after transplantation, which shows that the GAVE is not related to portal hypertension but is rather a direct consequence of liver failure. Possible pathophysiologic mechanisms are discussed. (+info)Review article: current therapeutic options for gastric antral vascular ectasia. (5/22)
Gastric antral vascular ectasia, or 'watermelon stomach', is a rare but important cause of gastrointestinal blood loss and anaemia, which has characteristic endoscopic and histological features. The pathogenesis of this condition remains unclear; however, many associated disorders have been documented. Various medical, surgical and endoscopic therapeutic modalities have been attempted with variable success. Leading contenders for the therapeutic modality of choice include hormonal therapy, endoscopic Nd:YAG laser and argon plasma coagulation. Randomized controlled trials to identify the ideal treatment method are lacking at present. (+info)Watermelon stomach: clinical aspects and treatment with argon plasma coagulation. (6/22)
BACKGROUND: Gastric antral vascular ectasia is a disorder whose pathogenetic mechanism is unknown. The endoscopic treatment with argon plasma coagulation has been considered one of the best endoscopic therapeutic options. AIM: To analyze the endoscopic and clinical features of gastric antral vascular ectasia and its response to the argon plasma coagulation treatment. PATIENTS AND METHODS: Eighteen patients were studied and classified into two groups: group 1--whose endoscopic aspect was striped (watermelon) or of the diffuse confluent type; group 2--diffuse spotty nonconfluent endoscopic aspect. RESULTS: Group 1 with eight patients, all having autoimmune antibodies, but one, whose antibodies were not searched for. Three were cirrhotic and three had hypothyroidism. All had gastric mucosa atrophy. In group 2, with 10 patients, all had non-immune liver disease, with platelet levels below 90,000. Ten patients were submitted to argon plasma coagulation treatment, with 2 to 36 months of follow-up. Lesions recurred in all patients who remained in the follow-up program and one did not respond to treatment for acute bleeding control. CONCLUSION: There seem to be two distinct groups of patients with gastric antral vascular ectasia: one related to immunologic disorders and other to non-immune chronic liver disease and low platelets. The endoscopic treatment using argon plasma coagulation had a high recurrence in the long-term evaluation. (+info)Does capsule endoscopy recognise gastric antral vascular ectasia more frequently than conventional endoscopy? (7/22)
BACKGROUND: Gastric antral vascular ectasia (GAVE) is a rare cause of obscure gastrointestinal bleeding which can be difficult to recognise endoscopically. Capsule endoscopy is primarily designed to image the small bowel, but may identify gastric and colonic lesions. There have been few reported cases of GAVE diagnosed by capsule endoscopy in the literature. OBJECTIVE: Our aim was to assess the frequency of GAVE in patients with obscure gastrointestinal bleeding referred for capsule endoscopy. DESIGN: Case series. SETTING: This study was conducted in a tertiary referral hospital. PATIENTS. This study comprised 128 consecutive patients with obscure gastrointestinal bleeding. INTERVENTIONS: All patients underwent capsule endoscopy. RESULTS. Six patients were diagnosed with GAVE on the basis of the capsule endoscopy findings (4.7%, five female, median age 71.5 years). All patients had previously had numerous gastrointestinal investigations prior to capsule endoscopy. Five patients to date have been treated with argon plasma coagulation of their vascular lesions. This has resulted in stabilisation of their haemoglobin and cessation of blood transfusions in 4/5 cases with an average follow up period of 15 months. CONCLUSIONS: GAVE is commonly missed at gastroscopy and accounted for 4.7% of patients referred for capsule endoscopy with obscure gastrointestinal bleeding (in our series). This case series represents the largest number of GAVE recognised by capsule endoscopy. In the presence of any of the reported risk/associated factors for GAVE the gastroenterologist interpreting the capsule images should have a high index of suspicion. (+info)Gastric antral vascular ectasia (GAVE) associated with systemic sclerosis: relapse after endoscopic treatment by argon plasma coagulation. (8/22)
In this report, we present a case of gastric antral vascular ectasia (GAVE) associated with systemic sclerosis and interstitial pneumonitis. This case showed resistance to endoscopic treatment using argon plasma coagulation (APC). After initial recognition of GAVE as the origin of persistent anemia, three sessions of APC were performed and dilated vessels on the antrum were eliminated completely. Five months after primary treatment, follow-up endoscopy revealed deformity of the gastric antrum caused by ulcer scars induced by APC, with no vascular ectasia. Ten months later, the patient showed anemia and recurrence of GAVE on endoscopy. Ablation using APC was performed again, thereby eradicating recurrent GAVE completely. At a two months' follow-up, however, recurrent GAVE was indicated. In spite of GAVE eradication by APC, a third recurrence of GAVE was observed after 32 months. During the follow-up period, systemic sclerosis and interstitial pneumonitis were controlled clinically by administration of methyl prednisolone with no aggravation. (+info)Gastric Antral Vascular Ectasia (GAVE) is a condition characterized by abnormal, dilated blood vessels in the antrum, which is the lower part of the stomach. These blood vessels can become fragile and prone to bleeding, leading to symptoms such as vomiting blood or having dark, tarry stools. GAVE is also sometimes referred to as "watermelon stomach" because the appearance of the affected area can resemble the stripes on a watermelon when viewed during endoscopy.
The exact cause of GAVE is not well understood, but it has been associated with conditions such as autoimmune disorders and chronic kidney disease. Treatment for GAVE typically involves addressing any underlying conditions and using various techniques to control bleeding, such as argon plasma coagulation or surgery.
Argon Plasma Coagulation (APC) is a medical procedure that uses ionized argon gas to deliver electrical current and heat to tissue, resulting in coagulation. It is commonly used in the treatment of gastrointestinal bleeding, as well as for cutting and coagulating during surgical procedures. The argon plasma is created by passing argon gas through a high-voltage electrical field, which ionizes the gas and creates a highly precise and controllable plasma beam. This beam can be directed at the tissue to achieve hemostasis (stopping bleeding) or to cut tissue with minimal thermal damage to surrounding structures. The procedure is often performed under endoscopic guidance.
The pyloric antrum is the distal part of the stomach, which is the last portion that precedes the pylorus and the beginning of the duodenum. It is a thickened, muscular area responsible for grinding and mixing food with gastric juices during digestion. The pyloric antrum also helps regulate the passage of chyme (partially digested food) into the small intestine through the pyloric sphincter, which controls the opening and closing of the pylorus. This region is crucial in the gastrointestinal tract's motor functions and overall digestive process.
Stomach diseases refer to a range of conditions that affect the stomach, a muscular sac located in the upper part of the abdomen and is responsible for storing and digesting food. These diseases can cause various symptoms such as abdominal pain, nausea, vomiting, heartburn, indigestion, loss of appetite, and bloating. Some common stomach diseases include:
1. Gastritis: Inflammation of the stomach lining that can cause pain, irritation, and ulcers.
2. Gastroesophageal reflux disease (GERD): A condition where stomach acid flows back into the esophagus, causing heartburn and damage to the esophageal lining.
3. Peptic ulcers: Open sores that develop on the lining of the stomach or duodenum, often caused by bacterial infections or long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs).
4. Stomach cancer: Abnormal growth of cancerous cells in the stomach, which can spread to other parts of the body if left untreated.
5. Gastroparesis: A condition where the stomach muscles are weakened or paralyzed, leading to difficulty digesting food and emptying the stomach.
6. Functional dyspepsia: A chronic disorder characterized by symptoms such as pain, bloating, and fullness in the upper abdomen, without any identifiable cause.
7. Eosinophilic esophagitis: A condition where eosinophils, a type of white blood cell, accumulate in the esophagus, causing inflammation and difficulty swallowing.
8. Stomal stenosis: Narrowing of the opening between the stomach and small intestine, often caused by scar tissue or surgical complications.
9. Hiatal hernia: A condition where a portion of the stomach protrudes through the diaphragm into the chest cavity, causing symptoms such as heartburn and difficulty swallowing.
These are just a few examples of stomach diseases, and there are many other conditions that can affect the stomach. Proper diagnosis and treatment are essential for managing these conditions and preventing complications.
Argon is a colorless, odorless, tasteless, and nonreactive noble gas that occurs in the Earth's atmosphere. It is chemically inert and is extracted from air by fractional distillation. Argon is used in various applications such as illumination, welding, and as a shielding gas in manufacturing processes.
In medical terms, argon is not commonly used as a therapeutic agent or medication. However, it has been used in some medical procedures such as argon laser therapy for the treatment of certain eye conditions like diabetic retinopathy and age-related macular degeneration. In these procedures, an argon laser is used to seal off leaking blood vessels or destroy abnormal tissue in the eye.
Overall, while argon has important uses in medical procedures, it is not a medication or therapeutic agent that is commonly administered directly to patients.
Gastrointestinal (GI) hemorrhage is a term used to describe any bleeding that occurs in the gastrointestinal tract, which includes the esophagus, stomach, small intestine, large intestine, and rectum. The bleeding can range from mild to severe and can produce symptoms such as vomiting blood, passing black or tarry stools, or having low blood pressure.
GI hemorrhage can be classified as either upper or lower, depending on the location of the bleed. Upper GI hemorrhage refers to bleeding that occurs above the ligament of Treitz, which is a point in the small intestine where it becomes narrower and turns a corner. Common causes of upper GI hemorrhage include gastritis, ulcers, esophageal varices, and Mallory-Weiss tears.
Lower GI hemorrhage refers to bleeding that occurs below the ligament of Treitz. Common causes of lower GI hemorrhage include diverticulosis, colitis, inflammatory bowel disease, and vascular abnormalities such as angiodysplasia.
The diagnosis of GI hemorrhage is often made based on the patient's symptoms, medical history, physical examination, and diagnostic tests such as endoscopy, CT scan, or radionuclide scanning. Treatment depends on the severity and cause of the bleeding and may include medications, endoscopic procedures, surgery, or a combination of these approaches.
Pathologic dilatation refers to an abnormal and excessive widening or enlargement of a body cavity or organ, which can result from various medical conditions. This abnormal dilation can occur in different parts of the body, including the blood vessels, digestive tract, airways, or heart chambers.
In the context of the cardiovascular system, pathologic dilatation may indicate a weakening or thinning of the heart muscle, leading to an enlarged chamber that can no longer pump blood efficiently. This condition is often associated with various heart diseases, such as cardiomyopathy, valvular heart disease, or long-standing high blood pressure.
In the gastrointestinal tract, pathologic dilatation may occur due to mechanical obstruction, neuromuscular disorders, or inflammatory conditions that affect the normal motility of the intestines. Examples include megacolon in Hirschsprung's disease, toxic megacolon in ulcerative colitis, or volvulus (twisting) of the bowel.
Pathologic dilatation can lead to various complications, such as reduced organ function, impaired circulation, and increased risk of infection or perforation. Treatment depends on the underlying cause and may involve medications, surgery, or other interventions to address the root problem and prevent further enlargement.
"Light coagulation," also known as "laser coagulation," is a medical term that refers to the use of laser technology to cauterize (seal or close) tissue. This procedure uses heat generated by a laser to cut, coagulate, or destroy tissue. In light coagulation, the laser beam is focused on the blood vessels in question, causing the blood within them to clot and the vessels to seal. This can be used for various medical purposes, such as stopping bleeding during surgery, destroying abnormal tissues (like tumors), or treating eye conditions like diabetic retinopathy and age-related macular degeneration.
It's important to note that this is a general definition, and the specific use of light coagulation may vary depending on the medical specialty and the individual patient's needs. As always, it's best to consult with a healthcare professional for more detailed information about any medical procedure or treatment.
Angiodysplasia is a vascular disorder characterized by the dilation and abnormal formation of blood vessels, particularly in the gastrointestinal (GI) tract. These abnormal blood vessels are prone to leakage or rupture, which can lead to bleeding. Angiodysplasia is most commonly found in the colon but can occur in other parts of the GI tract as well. It is more common in older adults and can cause symptoms such as anemia, fatigue, and bloody stools. The exact cause of angiodysplasia is not known, but it may be associated with chronic low-grade inflammation or increased pressure in the blood vessels. Treatment options include endoscopic therapies to stop bleeding, medications to reduce acid production in the stomach, and surgery in severe cases.
Gastroscopy is a medical procedure that involves the insertion of a gastroscope, which is a thin, flexible tube with a camera and light on the end, through the mouth and into the digestive tract. The gastroscope allows the doctor to visually examine the lining of the esophagus, stomach, and duodenum (the first part of the small intestine) for any abnormalities such as inflammation, ulcers, or tumors.
The procedure is usually performed under sedation to minimize discomfort, and it typically takes only a few minutes to complete. Gastroscopy can help diagnose various conditions, including gastroesophageal reflux disease (GERD), gastritis, stomach ulcers, and Barrett's esophagus. It can also be used to take tissue samples for biopsy or to treat certain conditions, such as bleeding or the removal of polyps.
Hemostasis, in general, refers to the process of stopping bleeding or hemorrhage, either naturally or through medical intervention. In the context of endoscopy, endoscopic hemostasis is the use of endoscopic techniques and devices to control gastrointestinal (GI) bleeding.
Endoscopes are flexible tubes with a light and camera at the tip, which are inserted into the body to visualize internal organs. In the case of GI endoscopy, the endoscope is inserted through the mouth or rectum to examine the esophagus, stomach, small intestine, large intestine, or rectum.
Endoscopic hemostasis techniques can be broadly categorized into two types:
- Mechanical methods: These involve the use of devices that physically occlude or constrict blood vessels to stop bleeding. Examples include hemoclips, which are metal clips that are deployed through the endoscope to grasp and compress a bleeding vessel, and band ligation, where a rubber band is used to strangulate a bleeding vessel.
- Thermal methods: These use heat to coagulate (seal) blood vessels and stop bleeding. Examples include monopolar and bipolar electrocoagulation, argon plasma coagulation, and laser coagulation.
Endoscopic hemostasis is an important tool in the management of acute GI bleeding, as well as prevention of rebleeding in patients with chronic or recurrent GI bleeding.
Gastrointestinal endoscopy is a medical procedure that allows direct visualization of the inner lining of the digestive tract, which includes the esophagus, stomach, small intestine, large intestine (colon), and sometimes the upper part of the small intestine (duodenum). This procedure is performed using an endoscope, a long, thin, flexible tube with a light and camera at its tip. The endoscope is inserted through the mouth for upper endoscopy or through the rectum for lower endoscopy (colonoscopy), and the images captured by the camera are transmitted to a monitor for the physician to view.
Gastrointestinal endoscopy can help diagnose various conditions, such as inflammation, ulcers, tumors, polyps, or bleeding in the digestive tract. It can also be used for therapeutic purposes, such as removing polyps, taking tissue samples (biopsies), treating bleeding, and performing other interventions to manage certain digestive diseases.
There are different types of gastrointestinal endoscopy procedures, including:
1. Upper Endoscopy (Esophagogastroduodenoscopy or EGD): This procedure examines the esophagus, stomach, and duodenum.
2. Colonoscopy: This procedure examines the colon and rectum.
3. Sigmoidoscopy: A limited examination of the lower part of the colon (sigmoid colon) using a shorter endoscope.
4. Enteroscopy: An examination of the small intestine, which can be performed using various techniques, such as push enteroscopy, single-balloon enteroscopy, or double-balloon enteroscopy.
5. Capsule Endoscopy: A procedure that involves swallowing a small capsule containing a camera, which captures images of the digestive tract as it passes through.
Gastrointestinal endoscopy is generally considered safe when performed by experienced medical professionals. However, like any medical procedure, there are potential risks and complications, such as bleeding, infection, perforation, or adverse reactions to sedatives used during the procedure. Patients should discuss these risks with their healthcare provider before undergoing gastrointestinal endoscopy.
Raynaud's disease, also known as Raynaud's phenomenon or syndrome, is a condition that affects the blood vessels, particularly in the fingers and toes. It is characterized by episodes of vasospasm (constriction) of the small digital arteries and arterioles, which can be triggered by cold temperatures or emotional stress. This results in reduced blood flow to the affected areas, causing them to become pale or white and then cyanotic (blue) due to the accumulation of deoxygenated blood. As the episode resolves, the affected areas may turn red as blood flow returns, sometimes accompanied by pain, numbness, or tingling sensations.
Raynaud's disease can be primary, meaning it occurs without an underlying medical condition, or secondary, which is associated with connective tissue disorders, autoimmune diseases, or other health issues such as carpal tunnel syndrome, vibration tool usage, or smoking. Primary Raynaud's is more common and tends to be less severe than secondary Raynaud's.
Treatment for Raynaud's disease typically involves avoiding triggers, keeping the body warm, and using medications to help dilate blood vessels and improve circulation. In some cases, lifestyle modifications and smoking cessation may also be recommended to manage symptoms and prevent progression of the condition.
Localized scleroderma, also known as morphea, is a rare autoimmune disorder that affects the skin and connective tissues. It is characterized by thickening and hardening (sclerosis) of the skin in patches or bands, usually on the trunk, limbs, or face. Unlike systemic scleroderma, localized scleroderma does not affect internal organs, although it can cause significant disfigurement and disability in some cases.
There are two main types of localized scleroderma: plaque morphea and generalized morphea. Plaque morphea typically presents as oval or circular patches of thickened, hard skin that are often white or pale in the center and surrounded by a purple or darker border. Generalized morphea, on the other hand, is characterized by larger areas of sclerosis that can cover much of the body surface.
The exact cause of localized scleroderma is not fully understood, but it is thought to involve an overactive immune system response that leads to inflammation and scarring of the skin and underlying tissues. Treatment typically involves a combination of topical therapies (such as corticosteroids or calcineurin inhibitors), phototherapy, and systemic medications (such as methotrexate or mycophenolate mofetil) in more severe cases.
Pruritus is a medical term derived from Latin, in which "prurire" means "to itch." It refers to an unpleasant sensation on the skin that provokes the desire or reflex to scratch. This can be caused by various factors, such as skin conditions (e.g., dryness, eczema, psoriasis), systemic diseases (e.g., liver disease, kidney failure), nerve disorders, psychological conditions, or reactions to certain medications.
Pruritus can significantly affect a person's quality of life, leading to sleep disturbances, anxiety, and depression. Proper identification and management of the underlying cause are essential for effective treatment.
Systemic Scleroderma, also known as Systemic Sclerosis (SSc), is a rare, chronic autoimmune disease that involves the abnormal growth and accumulation of collagen in various connective tissues, blood vessels, and organs throughout the body. This excessive collagen production leads to fibrosis or scarring, which can cause thickening, hardening, and tightening of the skin and damage to internal organs such as the heart, lungs, kidneys, and gastrointestinal tract.
Systemic Scleroderma is characterized by two main features: small blood vessel abnormalities (Raynaud's phenomenon) and fibrosis. The disease can be further classified into two subsets based on the extent of skin involvement: limited cutaneous systemic sclerosis (lcSSc) and diffuse cutaneous systemic sclerosis (dcSSc).
Limited cutaneous systemic sclerosis affects the skin distally, typically involving fingers, hands, forearms, feet, lower legs, and face. It is often associated with Raynaud's phenomenon, calcinosis, telangiectasias, and pulmonary arterial hypertension.
Diffuse cutaneous systemic sclerosis involves more extensive skin thickening and fibrosis that spreads proximally to affect the trunk, upper arms, thighs, and face. It is commonly associated with internal organ involvement, such as interstitial lung disease, heart disease, and kidney problems.
The exact cause of Systemic Scleroderma remains unknown; however, it is believed that genetic, environmental, and immunological factors contribute to its development. There is currently no cure for Systemic Scleroderma, but various treatments can help manage symptoms, slow disease progression, and improve quality of life.
CREST syndrome is a subtype of a autoimmune connective tissue disorder called scleroderma (systemic sclerosis). The name "CREST" is an acronym that stands for the following five features:
* Calcinosis: The formation of calcium deposits in the skin and underlying tissues, which can cause painful ulcers.
* Raynaud's phenomenon: A condition in which the blood vessels in the fingers and toes constrict in response to cold or stress, causing the digits to turn white or blue and become numb or painful.
* Esophageal dysmotility: Difficulty swallowing due to weakened muscles in the esophagus.
* Sclerodactyly: Thickening and tightening of the skin on the fingers.
* Telangiectasias: Dilated blood vessels near the surface of the skin, causing red spots or lines.
It's important to note that not everyone with CREST syndrome will have all five of these features, and some people may have additional symptoms not included in the acronym. Additionally, CREST syndrome is a chronic condition that can cause a range of complications, including lung fibrosis, kidney problems, and digital ulcers. Treatment typically focuses on managing specific symptoms and slowing the progression of the disease.
Diffuse scleroderma is a medical condition that falls under the systemic sclerosis category of autoimmune rheumatic diseases. It is characterized by thickening and hardening (sclerosis) of the skin and involvement of internal organs. In diffuse scleroderma, the process affects extensive areas of the skin and at least one internal organ.
The disease process involves an overproduction of collagen, a protein that makes up connective tissues in the body. This excessive collagen deposition leads to fibrosis (scarring) of the skin and various organs, including the esophagus, gastrointestinal tract, heart, lungs, and kidneys.
Diffuse scleroderma can present with a rapid progression of skin thickening within the first few years after onset. The skin involvement may extend to areas beyond the hands, feet, and face, which are commonly affected in limited scleroderma (another form of systemic sclerosis). Additionally, patients with diffuse scleroderma have a higher risk for severe internal organ complications compared to those with limited scleroderma.
Early diagnosis and appropriate management of diffuse scleroderma are crucial to prevent or slow down the progression of organ damage. Treatment typically involves a multidisciplinary approach, focusing on symptom management, immunosuppressive therapy, and addressing specific organ involvement.
Limited scleroderma, also known as limited cutaneous systemic sclerosis (lcSSc), is a subtype of scleroderma, a chronic autoimmune connective tissue disease. In this form, the fibrosis or hardening and thickening of the skin is generally limited to areas below the elbows and knees, as well as the face and neck.
The limited cutaneous form often involves the hands, causing a tightening of the skin on the fingers, known as "sclerodactyly." It can also affect the internal organs, but this is usually less severe and occurs later in the disease course compared to diffuse scleroderma.
A common characteristic of limited scleroderma is the presence of CREST syndrome, an acronym for Calcinosis, Raynaud's phenomenon, Esophageal dysmotility, Sclerodactyly, and Telangiectasia. These are specific symptoms associated with this subtype.
However, it is important to note that the manifestations of scleroderma can vary significantly from person to person, and not everyone with limited scleroderma will develop all the features of CREST syndrome.
Gastric antral vascular ectasia
Vitamin B12
Therapeutic endoscopy
Portal hypertensive gastropathy
Systemic scleroderma
Ectasia
Vitamin B12 deficiency
Gastrointestinal disease
Argon plasma coagulation
List of MeSH codes (C06)
Transjugular intrahepatic portosystemic shunt
Gastric varices
Esophagogastroduodenoscopy
List of MeSH codes (C14)
GAVE
Antrectomy
Upper gastrointestinal bleeding
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Watermelon2
- Gastric antral vascular ectasia ('watermelon stomach') is a rare cause of chronic gastrointestinal bleeding and various medical and surgical treatments have been described. (bmj.com)
- Gastric antral vascular ectasia (watermelon stomach or GAVE) consists of large dilated veins running linearly along the stomach, creating a striped appearance suggestive of a watermelon. (merckmanuals.com)
Angiodysplasia7
- Angiodysplasia is the most common vascular lesion of the gastrointestinal tract, and this condition may be asymptomatic, or it may cause gastrointestinal (GI) bleeding. (medscape.com)
- Angiodysplasia is the most common vascular abnormality of the GI tract. (medscape.com)
- Unlike small vascular ectasia or angiodysplasia, colonic AVM tends to be solitary, large in size, and identified endoscopically as flat or as an elevated bright red lesion. (medscape.com)
- Angiodysplasia may present as an isolated lesion or as multiple vascular lesions. (medscape.com)
- In 40-60% of patients with gastric and duodenal angiodysplasia, multiple lesions are observed at endoscopy. (medscape.com)
- Angiodysplasia, a vascular malformation, is the most common cause of recurrent lower intestinal hemorrhage in patients with renal failure. (medscape.com)
- Heyde Syndrome is a rare condition characterised by a triad of aortic stenosis, acquired coagulopathy and anaemia secondary to gastrointestinal bleeding leading to angiodysplasia i.e vascular malformation in the gut. (epainassist.com)
Argon Plasma Coag2
- Endoscopic treatment of gastric antral vascular ectasia in real‐life settings: argon plasma coagulation or endoscopic band ligation? (u-szeged.hu)
- Endoscopic therapy (argon plasma coagulation, radiofrequency ablation or band ligation for PHG and gastric antral vascular ectasia) may be used for local treatment of PHG bleeding. (thesecretsofmedicine.com)
Lesions8
- however, confusion about the exact nature of these lesions resulted in a multitude of terms that included arteriovenous malformation , hemangioma , telangiectasia, and vascular ectasia. (medscape.com)
- Unlike congenital or neoplastic vascular lesions of the GI tract, this lesion is not associated with angiomatous lesions of the skin or other viscera. (medscape.com)
- Rendu-Osler-Weber syndrome) is an autosomal dominant disorder that causes multiple vascular lesions in various parts of the body, including the entire GI tract. (merckmanuals.com)
- Vascular lesions are painless. (merckmanuals.com)
- Vascular lesions are most commonly diagnosed endoscopically. (merckmanuals.com)
- Endoscopic coagulation (with heater probe, laser, argon plasma, or bipolar electrocoagulation) is effective for many vascular lesions. (merckmanuals.com)
- We studied the nonspecific nature of the histologic findings in the gastric antral vascular ectasia (GAVE) syndrome by using a morphometric comparison with common gastric lesions including hyperplastic polyps and gastritis. (omeka.net)
- The procedural log should contain the number of diagnostic and therapeutic procedures performed as well as various types of intervention including endoscopic hemostasis of ulcer disease or other vascular lesions, ligation or sclerotherapy of varices, stricture dilation, foreign body removal, and PEG tube placements. (abdominalkey.com)
Endoscopy1
- However, endoscopy is most important for diagnosis of esophageal and gastric varices. (alaska-disability.com)
Varices2
- Part A of the listing recognizes that severe liver disease can cause varices and their potential complication of life-threatening bleeding in the esophagus and stomach (gastric varices). (alaska-disability.com)
- N-butyl-cyanoacrylate/thrombin) is recommended for acute bleeding from isolated gastric varices and type 2 gastro-oesophageal varices that extend beyond the cardia. (thesecretsofmedicine.com)
Malformation1
- In 1960, Margulis and colleagues identified a vascular malformation in the cecum of a 69-year-old woman who presented with massive bleeding. (medscape.com)
Gastritis3
- Severe Anemia Caused by Gastric Antral Vascular Ectasia and Autoimmune Gastritis. (bvsalud.org)
- His blood test revealed severe anemia , and gastroscopy revealed findings consistent with gastric antral vascular ectasia (GAVE) and autoimmune gastritis . (bvsalud.org)
- In pathological terms, gastritis is defined as inflammation of the gastric mucosa. (cmej.org.za)
Endoscopic3
- Endoscopic Band Ligation in the Treatment of Gastric Antral Vascular Ectasia: A Systematic Review and Meta-Analysis. (practicalgastro.com)
- Interventions: Endoscopic RFA to the gastric antrum using the HALO 90 ULTRA ablation catheter until transfusion independence is achieved or a maximum of 4 sessions are performed. (houstonmethodist.org)
- Vascular ectasias are treated with endoscopic coagulation if they are thought to be the cause of bleeding. (merckmanuals.com)
Lesion1
- A distinct vascular lesion in the PYLORIC ANTRUM that is characterized by tortuous dilated blood vessels ( ectasia ) radiating outward from the PYLORUS . (online-medical-dictionary.org)
GAVE4
- Gastric antral vascular ectasia (GAVE) is an uncommon cause of chronic gastrointestinal bleeding or iron deficiency anemia. (wikipedia.org)
- GAVE is associated with a number of conditions, including portal hypertension, chronic kidney failure, and collagen vascular diseases. (wikipedia.org)
- Background: Gastric antral vascular ectasia (GAVE) is a cause of upper GI bleeding and chronic anemia. (houstonmethodist.org)
- With this condition (also known as GAVE (Gastric Antral Vascular Ectasia) , the blood vessels in the lining of the stomach become fragile and prone to rupture and bleeding. (covenanthealth.com)
Abnormalities3
- Vascular abnormalities as a source of active bleeding were once considered controversial. (medscape.com)
- They are thought to be degenerative and do not occur in association with other vascular abnormalities. (merckmanuals.com)
- These vascular abnormalities are either congenital in nature or are associated with underlying systemic disorders such as Heyde Syndrome. (epainassist.com)
Treatment5
- Gastric antral vascular ectasia: maintenance treatment with oestrogen-progesterone. (bmj.com)
- Disease-modifying treatment aims at inhibiting tissue fibrosis and vascular and immune system alterations, which are the three crucial components of disease pathogenesis. (medscape.com)
- A Girl With a Gastric Trichobezoar This unusual cause of epigastric pain in children requires multidisciplinary treatment. (medscape.com)
- Gastric Antral Vascular Ectasia: An Ongoing Case This case describes a typical presentation of a patient with gastric antral vascular ectasia and the treatment course. (medscape.com)
- Both RFA systems have official approval to be used in the United States, Europe, and other countries for the treatment of BE as well as in patients with gastric antral vascular ectasia and radiation proctopathy. (peoplebeatingcancer.org)
Aortic stenosis2
- Vascular ectasias also occur in association with a number of systemic diseases (eg, renal failure, aortic stenosis, cirrhosis, CREST syndrome [calcinosis cutis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, telangiectasias]) and after radiation to the bowel. (merckmanuals.com)
- The exact correlation between aortic stenosis and gastric tract bleeding has still not been confirmed. (epainassist.com)
Diffuse1
- When there are red spots throughout the stomach, the term diffuse gastric vascular ectasia is used. (alaska-disability.com)
Cecum1
- Vascular ectasias (angiodysplasias, arteriovenous malformations) are dilated, tortuous vessels that typically develop in the cecum and ascending colon. (merckmanuals.com)
Esophageal1
- Esophageal manometry is typically performed to evaluate the symptoms of gastric reflux, heartburn, difficulty swallowing, regurgitation, and functional chest pain. (covenanthealth.com)
Dilation1
- Acquired degenerative dilation or expansion (ectasia) of normal BLOOD VESSELS, often associated with aging. (ucdenver.edu)
Hereditary hemorrhagic te1
- Kilari S, Wang Y, Singh A, Graham RP, Iyer V , Thompson SM, Torbenson MS, Mukhopadhyay D, Misra S. Neuropilin-1 deficiency in vascular smooth muscle cells is associated with hereditary hemorrhagic telangiectasia arteriovenous malformations. (mayo.edu)
Esophagus1
- Collagen Vascular Disorders, Esophagus. (booksdo.com)
Severe1
- A syndrome that is characterized by the triad of severe PEPTIC ULCER, hypersecretion of GASTRIC ACID, and GASTRIN-producing tumors of the PANCREAS or other tissue (GASTRINOMA). (wakehealth.edu)
Large1
- Phillips first described a vascular abnormality that caused bleeding from the large bowel in a letter to the London Medical Gazette in 1839. (medscape.com)
Coagulation9
- We report two patients treated with Argon Plasma Coagulation, a 68 years old male with an ethanol related cirrhosis and a 72 years old female with an idiopathic Gastric Antral Vascular Ectasia. (uandes.cl)
- 1. Comparison of Endoscopic Radiofrequency Ablation and Argon Plasma Coagulation in Patients with Gastric Low-Grade Intraepithelial Neoplasia: A Large-Scale Retrospective Study. (nih.gov)
- 4. The Usefulness of Argon Plasma Coagulation Compared with Endoscopic Submucosal Dissection to Treat Gastric Adenoma. (nih.gov)
- 5. Comparative Effectiveness and Safety of Radiofrequency Ablation Versus Argon Plasma Coagulation for Treatment of Gastric Antral Vascular Ectasia: A Systematic Review and Meta-Analysis. (nih.gov)
- 8. Ablation of residual gastric tumor by argon plasma coagulation after endoscopic resection. (nih.gov)
- 10. Cost-effectiveness and short-term clinical outcomes of argon plasma coagulation compared with endoscopic submucosal dissection in the treatment of gastric low-grade dysplasia. (nih.gov)
- 11. Argon plasma coagulation with submucosal saline injection for gastric adenoma on outpatient basis. (nih.gov)
- 14. Radiofrequency ablation (RFA) vs. argon plasma coagulation (APC) for the management of gastric antral vascular ectasia (GAVE) in patients with and without cirrhosis: results from a retrospective analysis of a large cohort of patients treated at a single center. (nih.gov)
- Vascular ectasias are treated with endoscopic coagulation if they are thought to be the cause of bleeding. (merckmanuals.com)
Endoscopic therapy1
- 9. The cost-effectiveness of radiofrequency ablation for treating patients with gastric antral vascular ectasia refractory to first line endoscopic therapy. (nih.gov)
Antrum6
- Gastric antrum, as seen during the initial endoscopy, prior to any treatment. (medscape.com)
- Gastric antrum during the second endoscopy, after completion of APC treatment. (medscape.com)
- Gastric antrum during the third endoscopy, after completion of APC treatment. (medscape.com)
- A distinct vascular lesion in the PYLORIC ANTRUM that is characterized by tortuous dilated blood vessels (ectasia) radiating outward from the PYLORUS . (nih.gov)
- Since the procedure leaves the vagal branches to the antrum and PYLORUS intact, it circumvents gastric drainage required with truncal vagotomy techniques. (lookformedical.com)
- The clinical manifestations are focused in the stomach, usually the gastric mucosa and antrum, and the upper duodenum. (lookformedical.com)
Systemic2
- Gastric antral vascular ectasia in systemic sclerosis: Association with anti-RNA polymerase III and negative anti-nuclear antibodies. (harvard.edu)
- Vascular ectasias also occur in association with a number of systemic diseases (eg, renal failure, aortic stenosis, cirrhosis, CREST syndrome [calcinosis cutis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, telangiectasias]) and after radiation to the bowel. (merckmanuals.com)
Stomach4
- Part A of the listing recognizes that severe liver disease can cause varices and their potential complication of life-threatening bleeding in the esophagus and stomach (gastric varices). (disabilitylawyersmiami.com)
- When there are red spots throughout the stomach, the term diffuse gastric vascular ectasia is used. (disabilitylawyersmiami.com)
- Peptic ulcer disease encompasses both gastric (stomach) and duodenal (upper part of the small intestine) ulcers. (heartsense.in)
- Vagal denervation of that part of the STOMACH lined with acid-secreting mucosa (GASTRIC MUCOSA) containing the GASTRIC PARIETAL CELLS. (lookformedical.com)
Refractory2
Esophageal1
- American Society for Gastrointestinal Endoscopy guideline on endoscopic submucosal dissection for the management of early esophageal and gastric cancers: methodology and review of evidence. (umassmed.edu)
Gastrointestinal tract1
- Ulcer that occurs in the regions of the GASTROINTESTINAL TRACT which come into contact with GASTRIC JUICE containing PEPSIN and GASTRIC ACID. (lookformedical.com)
Tortuous1
- Vascular ectasias (angiodysplasias, arteriovenous malformations) are dilated, tortuous vessels that typically develop in the cecum and ascending colon. (merckmanuals.com)
Pylori4
- BACKGROUND: Non-Helicobacter pylori Helicobacter (NHPH) has recently been linked to various gastric diseases. (bvsalud.org)
- MATERIALS AND METHODS: Formalin-fixed paraffin-embedded tissues were obtained from 73 patients with gastric cancer, of whom 21 cases were Helicobacter pylori (Hp) current infection, 37 cases were Hp previous infection, and 15 cases were Hp naïve infection, and were screened for NPHPs using polymerase chain reaction. (bvsalud.org)
- Besides peptic ulcer disease, Helicobacter pylori have been linked to several other gastric disorders and complications. (heartsense.in)
- H. pylori infection is a significant risk factor for the development of gastric cancer. (heartsense.in)
Resection4
- Objectives: Complete en-bloc resection of pedunculated colorectal carcinoma is necessary for a proper pathological diagnosis. (bvsalud.org)
- However, due to poor visibility, large pedunculated colorectal carcinomas are difficult to snare and resect en-bloc using endoscopic resection or polypectomy. (bvsalud.org)
- The en-bloc, complete en-bloc, and curative resection rates were 97% (35/36), 97% (35/36), and 81% (29/36), respectively. (bvsalud.org)
- Influence of race and sociodemographic factors on declining resection for gastric cancer: A national study. (umassmed.edu)
Malformations1
- Angiogenesis and vascular malformations: antiangiogenic drugs for treatment of gastrointestinal bleeding. (nih.gov)
Bacterium1
- A spiral bacterium active as a human gastric pathogen. (lookformedical.com)
Leak1
- A clinical case of a 52-year-old patient with a history of gastric sleeve surgery and anastomotic leak is presented. (bvsalud.org)
Occur1
- They are thought to be degenerative and do not occur in association with other vascular abnormalities. (merckmanuals.com)
Sleeve2
- Gastrointestinal bleeding caused by a fistula between the gastric sleeve and a pseudoaneurysm of the splenic artery or upper pole of the spleen is uncommon. (bvsalud.org)
- She underwent emergency surgery and performed a hemostatic stitch on the posterior face of the gastric sleeve. (bvsalud.org)
Infection5
- However, the relationship between NHPH infection and gastric cancer remains controversial. (bvsalud.org)
- This study aimed to identify the effect of NHPH infection on gastritis and gastric cancer development. (bvsalud.org)
- We evaluated the association of NHPH infection with gastritis and clinicopathological features of gastric cancer. (bvsalud.org)
- NHPH infection rates in gastric cancer patients were similar to those in the patients with gastritis-related diseases reported in the previous study. (bvsalud.org)
- CONCLUSIONS: The association between gastric cancer and NHPH infection would have important implications for gastric cancer prevention, diagnostics, and treatment, however, no significant association was found in this particular population. (bvsalud.org)
Patients5
- A comparison of NHPH-positive and negative patients showed no significant differences in atrophic gastritis status, serum gastritis markers, or clinicopathological characteristics of gastric cancer, such as localization, size, gross type, differentiation, or depth. (bvsalud.org)
- Cette collaboration permet une prise en charge optimisée pour les patients atteints de maladies rares du foie, tout en privilégiant toujours une prise en charge locale dans le bassin de vie du patient. (aphp.fr)
- Ces centres sont officiellement labellisés par le ministère de la Santé dans le cadre des plans nationaux maladies rares qui ont pour objectif de structurer pour les maladies rares une offre de soins de haut niveau et d'améliorer la visibilité du dispositif ainsi mis en place aussi bien pour les patients que pour les professionnels de santé. (aphp.fr)
- Methods: The clinical data of CTPV patients with patency or partial patency of the superior mesenteric vein treated with TIPS or TEPS treatment in the Department of Vascular Surgery of Henan Provincial People's Hospital from January 2019 to December 2021 were selected. (bvsalud.org)
- Acupuncture for Quality of Life in Gastric Cancer Patients Undergoing Adjuvant Chemotherapy. (umassmed.edu)
Cancer1
- Yao H, Sun L, Li J, Zhou X, Li R, Shao R, Zhang Y, Li L. A Novel Therapeutic siRNA Nanoparticle Designed for Dual-Targeting CD44 and Gli1 of Gastric Cancer Stem Cells. (umassmed.edu)
Study1
- [ 105 ] A gastric emptying study should be performed to document delayed gastric emptying. (medscape.com)
Clinical2
- 2. Clinical efficacy and prognostic risk factors of endoscopic radiofrequency ablation for gastric low-grade intraepithelial neoplasia. (nih.gov)
- The Discordance of Clinical and Pathologic Staging in Locally Advanced Gastric Adenocarcinoma. (umassmed.edu)
Present1
- Hydrochloric acid present in GASTRIC JUICE. (lookformedical.com)
Portal1
- CT of the abdomen showed circumferential gastric wall thickening, normal sized liver with smooth contour, no liver mass, and normal portal and hepatic veins. (medscape.com)