A Case of Gastric Antral Vascular Ectasia that Underwent Laparoscopic Distal Gastrectomy

Abstract

A 73-year-old woman underwent coronary artery bypass grafting and aortic valve replacement for effort angina and aortic valve stenosis in February 2017, and she was put on aspirin and warfarin potassium after the surgery. In October, anemia was found on a blood test, and esophagogastroduodenoscopy showed bleeding from gastric antral vascular ectasia (GAVE). She had recurrent bleeding from the GAVE, and argon plasma coagulation (APC) was performed 20 times from then to 2020. An echocardiogram in June 2020 showed hypokinesis caused by ischemia due to decreasing blood flow of the bypass graft, and percutaneous coronary intervention (PCI) was performed. In addition, her renal function was decreasing gradually, and initiation of dialysis was planned. Since the risk of bleeding from the GAVE was expected to increase with dual antiplatelet therapy after PCI and anticoagulation during dialysis, this case was considered a candidate for surgery. In August 2020, laparoscopic distal gastrectomy (LDG) was performed for the GAVE, and she was discharged on postoperative day 11 with a good postoperative course. No bleeding from the stomach has been observed up to 26 months after the surgery. LDG is safe and should be considered as an early surgical treatment option for GAVE.