Gastric antral vascular ectasia

Gastric antral vascular ectasia (GAVE), also known as watermelon stomach, is a rare condition affecting the stomach. It is one of the diagnoses to consider in older patients with severe anemia and occult or profuse gastrointestinal bleeding (especially in those with cardiac, liver, or renal diseases).

It can be a significant cause of severe acute or chronic gastrointestinal blood loss in the elderly.

While it is rare, it may account for up to 4% of non-variceal upper gastrointestinal blood loss.

Its pathogenesis is unknown although it is associated with heterogeneous conditions, including various hepatic, renal 6, and cardiac diseases.

Pathognomonic red vascular folds (which have been likened to stripes on a watermelon) may be seen on endoscopic evaluation. A histologic hallmark is the presence of superficial fibromuscular hyperplasia of gastric antral mucosa with capillary ectasia and microvascular thrombosis in the lamina propria.

Findings include

  • prominent, scalloped antral folds radiating to the pylorus
  • thickening of the gastric antrum.

It was first described by J A Rider et al. in 1953 3.

Article information

rID: 34425
Tag: cases, cases
Synonyms or Alternate Spellings:
  • Gastric antral valvular ectasia (GAVE)
  • Gastric antral vascular ectasia (GAVE) syndrome
  • GAVE syndrome
  • Watermelon stomach
  • Watermelon stomach (WS)

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