Compare APC to other treatments modalities in patients with GAVE syndrome
Ammar Shahin, Hassan Zaid
Department of Gastroenterology, St. James's Hospital. Dublin 8
GAVE syndrome, or watermelon stomach, though is a rare condition, but a cause of recurrent admissions with symptomatic anaemia that requires blood transfusion. It usually presents with iron deficiency anaemia due to overt gastrointestinal (GI) bleeding. Several treatment options are available with different outcome and success rates. Argon Plasma Coagulation (APC), has been considered the treatment of choice with growing opinion using alternative methods with better outcome including Radio- Frequency Ablation (RFA) and Endoscopic Band Ligation (EBL).
To compare the Haemoglobin levels, blood transfusion requirements and iron studies in our panel of GAVE patients who required frequent blood transfusions who are treated with Argon Plasma Coagulation (APC) versus other available modalities, i.e. Endoscopic banding ligation and radiofrequency ablation.
APC has been used more frequently as the treatment of choice for GAVE in our hospital The charts of the patients whose OGD revealed GAVE syndrome were reviewed. Their haemoglobins, blood transfusion requirements and the frequency of receiving APC treatments were recorded. Findings were compared to the results of the patients who were treated with other available interventions, i.e. RFA or EBL
Changes of GAVE was found in 35 patients who has OGD within 1 year. The majority of these patients were either elderly females with idiopathic GAVE or younger patients with chronic liver disease either alcohol or hepatitis C related. 18 patients had APC during the year of whom 8 had more than 3 sessions. 14 patients received 56 units of bloods during this year, 2 patients were referred from another hospital, who were received APC before, treated with Radio-Frequency Ablation (RFA), with significant reduction in blood transfusion requirement. 10 patients were treated with EBL which resulted in improvement of HB an reduction in blood transfusion requirement
1. GAVE though rare condition but may cause a recurrent anaemia with frequent blood transfusion requirement. 2. APC is more effective in mild to moderate disease. 3.Other treatments methods like EBL and RFA may be superior to APC in reducing anaemia and blood transfusion. 4.Patients with recurrent admissions with low Hb, who were treated before with APC alternative methods should be considered.