1995 Volume 37 Issue 10 Pages 2211-2215_1
A 90-year-old fernale was admitted because of dyspnea on exertion. Severe anemia(Hb 3.89/dl), cardiomegaly and leg edema were noted. Stool occult blood was positive.She was diagnosed to have heart failure caused by severe anemia. Endoscapic examination of the upper gastrointestinal tract revealed multiple eryth-ematous spots consisting, of vascular ectasia distributing from the upper body to theantrum. dozing hemorrhage were observed on several spots of those areas. However suchlesions were not observed on the greater curvature of the midde and upper bodies thegastric mucosa generally revealed marked atrophy. With these endascopic findings shewas diagnosed to have diffuse antral vascular ectasia DAVE. To control her generalconditions, she was treated with blood transfusion and diuretics. Although her heart failurewas improved, gastric bleeding could not be controlled by injections of absolute ethanoland/or hypertonic saline epinephrine into the bleeding spots through a gastric fiberscope. She died of pneumonia. Histological findings of the autopsy specimen revealed typicalfindings of DAVE such as increased mucosal vascuiarity, the presence of intravascuiarfibrin thrombi, fibrosis of the lamina propria and mucosal atrophy. Liver cirrhosis andchronic renal failure, which had been reported to be frequently associated, were absent inthis case.
