| Theme |
Vascular Disorder of Gastro-intestinal Tract |
| Title |
Pathogenesis of Gastric Antral Vascular Ectasia (GAVE) |
| Author |
Shinichi Nakamura |
Institute of Gastroenterology, Tokyo Women's Medical University |
| Author |
Hiromi Haruyama |
Institute of Gastroenterology, Tokyo Women's Medical University |
| Author |
Maiko Kishino |
Institute of Gastroenterology, Tokyo Women's Medical University |
| Author |
Hiroyuki Konishi |
Institute of Gastroenterology, Tokyo Women's Medical University |
| Author |
Keiko Shiratori |
Institute of Gastroenterology, Tokyo Women's Medical University |
| [ Summary ] |
Gastric antral vascular ectasia (GAVE) is characterized by diffuse vasodilation mainly affecting the antrum and causes gastrointestinal hemorrhaging. By employing endoscopy, GAVE with tachetic and diffuse vasodilation was defined as the diffuse type, while GAVE with striped and radiant punctuate flares was classified as the watermelon type. This condition usually occurs in patients with conditions including liver cirrhosis, chronic renal failure, aortic valvular disease and scleroderma. In histological studies, GAVE is characterized by; 1) marked dilatation of small and medium sized blood vessels in the stomach wall; 2) capillary dilation in the gastric mucosa and the presence of fibrin plugs. Regarding the etiology and pathology of GAVE, some theories have been reported, but details are unclear. These details include mechanical irritation due to promotion of peristalsis in the pyloric region, vasodilatory substances such as gastrin, fragile vessels due to portal hypertension and autoimmunity. Gastric diseases for which differential diagnosis distinguishing GAVE from other conditions must be made, including portal hypertensive gastropathy and radiation gastropathy. |