Naslov
Gastric antral vascular ectasia (GAVE) – pathohistology and clinical implications

Autori
Pavic, Ivana ; Demirovic, Alma ; Nikolic, Marko ; Boban, Marko ; Ljubicic, Neven ; Balicevic, Drinko Croatia

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, ostalo

Izvornik
Abstract book / - Zagreb, 2009

Skup
5. kongres Hrvatskog Gastroenterološkog Društva

Mjesto i datum
Dubrovnik, Hrvatska, 02.04.2009. - 05.04.2009

Vrsta sudjelovanja
Poster

Vrsta recenzije
Domaća recenzija

Ključne riječi
Gastric antral vascular ectasia (GAVE); portal hypertension gastropathy; gastritis; gastrointestinal bleeding
(Gastric antral vascular ectasia (GAVE); gastritis; portal hypertension gastropathy; gastrointestinal bleeding)

Sažetak
AIM: Gastric antral vascular ectasia (GAVE) is disorder not so common by occurrence with set of microscopic and/or endoscopic appearances of gastric mucosa. Most cases are idiopathic while reminders are secondary to cirrhosis or system sclerosis with various ambiguous points considering etiology, course and treatment. We aimed to analyze upper gastric endoscopies biopsies for GAVE, with respect to patohistologcial and clinical particularities. METHODS: a retrospective cross sectional study of 3100 consecutive upper gastrointestinal endoscopies routinely performed at Department of Gastroenterology in time period January 1st- December 31st 2008. Diagnose was established according to set of typical histological findings with standard hemalaun-eosine staining and immunohistochemistry regarding inconclusive specimens. RESULTS: There were found 2 cases of GAVE (0.065%) presenting as gastric antral polyps with spindle cell proliferation, fibrohyalinosis, vascular ectasia and thrombus. Patients, female 55 years of age and male 53, both without indicative co- morbidities, idiopathic cases represented as incidental findings in diagnostic workup. There was not found any abnormality regarding biochemical, hematological, microbiological or oncological laboratory diagnostic. DISCUSSION: Female patient in our study presented with chronic gastritis complaints lasting for years, had multiple repeated endoscopic biopsies that were unspecific and was treated with PPI without satisfying response. Changes in one sample from fundic part of the stomach were also inconclusive alike to GAVE, clinically diagnosed as moderate chronic gastritis. Histology was almost the same as two previously described but localization of the lesion and lack of spindle cell proliferation, fibrohyalinosis with mild ectasia, originated probably due to portal hypertensive gastropathy. Although etiology and associations are not fully understood patogenesis of GAVE could represent prolapsed of mobile mucosa through pylorus. CONCLUSION: differentiation of GAVE to portal hypertensive gastropathy or appearance resembling malignance particularly in setting of cirrhosis is clinically important regarding presentation, diagnostic misleads, therapy, follow up and outcome. If endoscopic finding is not clear differential diagnoses could be ruled out by patohystology. There is a high rate of false negative diagnosis regarding GAVE, due to the fact that lesions are focal, thus negative biopsy result does not exclude diagnose.

Izvorni jezik
Engleski

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