Argon Plasma Coagulation in the Management of Different Types of Gastric Vascular Ectasia: Experience in Egyptian Patients
M. Malatawy, Hanan M. Badawy, Nanees A. Adel, Eslam Safwat, Hany Haroun
Department of Internal Medicine, Faculty of Medicine, Ain Shams University
Abstract: Background: Gastric vascular ectasia (GVE) is a distinct vascular abnormality, including various subtypes. It is a well-known cause of gastrointestinal bleeding. Various endoscopic treatment modalities have been tried in this condition. Aim of the study: This study is designed to evaluate the efficacy of argon plasma coagulation (APC) on various subtypes of GVE. Patients & methods: From November 2010 to October 2011, thirty patients with different forms of GVE were enrolled, divided into 3 subgroups: portal hypertensive gastropathy (PHG) (n=10), focal vascular ectasia (FVE) (n=10), andgastric antral vascular ectasia (GAVE) (n=10). They were followed-up for 3 months with repeated sessions of APC. The APC settings were 30 to 40W and 1.5 to 2L/min of argon plasma flow. Efficacy of APC was evaluated on the basis of patient's symptoms, transfusion requirements, number of hospitalization, hemoglobin and haematocrit levels. Results: The mean number of APC sessions was 2.3±0.82, 2±0.81 and 1.9±0.87 in PHG, FVE and GAVE groups respectively. Patients with PHG were the most susceptible for re-bleeding (30%) after 1st APC session. The rise in haemoglobin was highly significant in all three groups (p=0.0001). A significant reduction in packed RBCs transfusion rates was also noted in the 3 groups (p=0.0001). No complications occurred. Conclusion: APC appears to be a simple, safe, and effective technique in the management of different forms gastric vascular ectasia lesions.
[M. Malatawy, Hanan M. Badawy, Nanees A. Adel, Eslam Safwat, Hany Haroun. Argon Plasma Coagulation in the Management of Different Types of Gastric Vascular Ectasia: Experience in Egyptian Patients. J Am Sci 2012;8(10):283-286]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 41
Keywords: gastric vascular ectasia, portal hypertensive gastropathy, argon plasma coagulation, Full Text 41