BACKGROUND
Gastric antral vascular ectasia (GAVE) is a rare clinical entity that presents with acute upper-gastrointestinal
bleeding or chronic
anemia. It is characterized by endoscopic watermelon appearance of the stomach. It is usually associated with other comorbidities; however, few articles have previously described GAVE in patients with
end-stage renal disease. Its management is controversial, and endoscopic management is considered the treatment of choice. CASE REPORT A middle-age female patient, on regular
hemodialysis for
ESRD, was referred to the surgical out-patient clinic as a refractory GAVE after failure of endoscopic management as she became
blood transfusion-dependent. She underwent laparoscopic subtotal
gastrectomy with a
Billroth II reconstruction of
gastrojejunostomy. She had a smooth postoperative course and was followed up in the clinic for 12 months with no complications. Her
hemoglobin level was stable at 9.4 g/dL without further
blood transfusion. CONCLUSIONS
Gastric antral vascular ectasia is usually associated with other comorbidities; however, an association between GAVE and CKD is rare. Its management is controversial, and endoscopic management is considered the preferred method of treatment. Laparoscopic subtotal
gastrectomy is an effective management modality for GAVE, with dramatic improvement and good outcomes in terms of
bleeding,
blood transfusion requirements, and nutritional status.