[Treatment of watermelon stomach (GAVE syndrome) with endoscopic argon plasma coagulation (APC). A new therapy approach].

Abstract

The case of a 74-year-old male patient with a watermelon stomach (GAVE-syndrome: gastric antral vascular ectasia) is reported. The superficial annual mucosa showed the characteristic picture of ectatic capillaries, some of them plugged with fibrin thrombi. Anemia due to chronic blood loss had developed in our patient. The vascular lesions of the antral mucosa were treated endoscopically in three sessions with an argon-plasma-coagulation (APC). Three months after completion of therapy the vascular changes of the antral mucosa had resolved almost completely. In addition no further blood loss had occurred. Many treatment modalities of the watermelon stomach abnormality exist. Nowadays, vaporization of the vascular lesions with the Neodym-Yag laser has widely replaced surgical treatment. The argon-plasma-coagulation uses instead of laser energy conduction of electric energy by ionized argon gas (plasma), which produces coagulation necrosis of tissues. The potential advantages of the argon-plasma-coagulation lie in the limited deep penetration, which reduces the risk of perforation and the symmetric spread of the coagulation effects in the surrounding mucosa. These properties make the argon plasma-coagulation a promising tool for the endoscopic therapy of mucosal lesions of the GI-tract. Further attractive is the low cost of the argon-plasma-coagulation equipment compared with laser devices.