Abstract
A 63-year-old male was admitted to the hospital because of tarry stool and progressive anemia. He had been on hemodialysis for 9 years and had liver cirrhosis. Endoscopic examination revealed diffuse gastric antral vascular ectasia with intensely reddish dots and oozing. Non-anticoagulant hemodialysis was prescribed together with transfusions and anti-ulcer agents. Although temporary hemostasis was achieved, anemia worsened after transarterial embolization therapy for hepatocellular carcinoma which had been recognized on computed tomography. Neither endoscopic clipping therapy nor heat coagulation therapy could stop the bleeding. The patient's condition was too poor to allow gastrectomy. Therefore, topical injection of polidocanol was performed endoscopically, and persistant hemostasis was achieved. Diffuse gastric antral vascular ectasia is usually refractory to conservative therapy and often requires a gastrectomy. However, as we have described herein, endoscopic screlotherapy may be effective for this disease even when conventional procedures have been unsuccessful.
