[Vascular ectasias of the gastric antrum as the cause of chronic digestive hemorrhage. Presentation of a case]

Abstract

Digestive hemorrhages are one of the syndromes, that frequently attracts the attention of the gastroenterologist-endoscopist. Sometimes it's not evident during upper endoscopy study and course with a contrast radiological scan. In the last years a vascular pathology has been seen which is responsible of high digestive hemorrhages. It is manifested by melaena and is originated by vascular ectasias, which are vascular dilatations present in the stomach or right colon during various accompanying pathologies like hepatic cirrhosis with portal hypertension, cardiac valvulopaties, etc. Here we present a 61 year old woman with a history of chronic hepatopathy of cirrhotic type and imprecise etiology (diagnosed since 1983). Approximately two years ago (1996-1997) she has been presenting digestive hemorrhages and she has been transfused in different occasions because she had severe anemia. Diffuse vascular ectasias in the distal region of the antrum and in part of the gastric body were observed during duodenoscopy and colonoscopy with signs of active hemorrhage and similar non-bleeding lesions in the colon. Pyruvic transaminase was normal; HBV and HCV -markers were -negative. Ultrasound analysis was normal. The diagnosis at the discharge from Hospital was Diffuse Vascular Ectasias of the Gastric Antrum and part of the gastric body, caecum and right colon, secondary to hepatic cirrhosis. She was admitted again at the hospital because of new upper digestive hemorrhages and surgery was indicated. Gastric resection was performed with promising results. This case is analyzed and the pathology is results.