Gastric antral vascular ectasia is an uncommon cause of chronic gastrointestinal bleeding or iron deficiency anemia. The condition is associated with dilated small blood vessels in the antrum, or the last part of the stomach. It is also called watermelon stomach because streaky long red areas that are present in the stomach may resemble the markings on watermelon^[1].

The condition was first discovered in 1952, and reported in the literature in 1953.^[1] Watermelon disease was first diagnosed by Wheeler et al. in 1979, and definitively described in four living patients by Jabbari et al. only in 1984. As of 2011, the etiology and pathogenesis are still not known.^[2] However, there are several competing hypotheses as to various etiologies.

GAVE is characterized by dilated capillaries in the lamina propria with fibrin thrombi.

GAVE is associated with a number of conditions, including

• Portal hypertension
• Chronic renal failure
• Collagen vascular diseases, particularly scleroderma
• Pernicious anemia
• Liver cirrhosis
• Chronic renal failure
• Bone marrow transplantation

65% of patients with both cirrhosis and GAVE are male, but a total of 30% have both conditions. The causal connection between cirrhosis and GAVE has not been proven.

A connective tissue disease has been suspected in some cases.

Autoimmunity may have something to do with it,^[1] as 25% of all sclerosis patients who had a certain anti-RNA marker have GAVE. RNA autoimmunity has been suspected as a cause or marker since at least 1996.

One theory current since the 1990s focuses on a history of prolapse of the stomach into the small intestine.

Gastrin levels may indicate a hormonal connection. This may be due to vasoactive intestinal peptide and 5-hydroxy-tryptamine.

It is also possible that infection by H. pylori can cause it.

GAVE should be differentiated from other causes of intestinal bleeding such as

• Duodenal ulcer
• Portal hypertension^[1]

The differential diagnosis is important because treatments are different.

The average age of diagnosis for GAVE is 73 years of age for females, and 68 for males. Patients in their thirties have been found to have GAVE. It becomes more common in women in their eighties, rising to 4% of all such gastrointestinal conditions.

Women are about twice as often diagnosed with gastric antral vascular ectasia than men. 71% of all cases of GAVE are diagnosed in females.

Please help WikiDoc by adding more content here. It’s easy! Click here to learn about editing.