What is the cause of gastric antral vascular ectasia

At present, the clinical cause of gastric antral vascular ectasia is not very clear, because it is usually accompanied by systemic diseases, such as chronic renal failure, hypertension, heart valve disease, etc., and clinically it will manifest symptoms of gastrointestinal bleeding.

1. Causes

The cause of the disease is currently unclear, and it is usually accompanied by systemic diseases such as cirrhosis, chronic renal failure, hypertension, heart valve disease, autoimmune diseases, etc.

The pathogenesis of GAVE is also unclear. It may be that mechanical and humoral factors work together to cause abnormal vascular development, and gastric acid and food in the stomach damage the submucosal congested blood vessels, resulting in clinically obvious bleeding.

2. Clinical manifestations

Chronic gastrointestinal bleeding is common, manifested by black stools, vomiting, etc., and may cause obvious refractory iron deficiency anemia, requiring reliance on regular blood transfusions. Oral iron supplements usually do not improve their symptoms of iron deficiency anemia. Some GAVE patients experience decreased gastric acid or achlorhydria, more than 90% of patients have chronic atrophic gastritis, and some may have hypergastrinemia.

3. Inspection

1. Laboratory examination

The main symptoms are iron deficiency anemia, and some patients may have thrombocytopenia.

2. Gastroscopy

(1) The typical coiled, ridged, dilated vascular tissue emanating from the pylorus in the gastric antrum;

(2) Radial flat strip-like mucosal lesions;

(3) scattered mucosal lesions;

(4) A rare “honeycomb stomach” may occur, which is a large, red, united vascular dysplastic lesion;

(5) In addition to the gastric antrum, the lesions may also affect other parts of the gastric mucosa, combined with extensive vascular dilatation in the duodenum and jejunum;

(6) GAVE under gastroscopy is often accompanied by pyloric mucosal prolapse, and dilated blood vessels and ecchymotic bleeding can be seen on the top of the prolapsed mucosa;

(7) Watermelon-like streaks found under gastroscopy are a unique manifestation of this disease;

(8) Gastroscopy biopsy is of great significance for diagnosis.