Efficacy of argon plasma coagulation in gastric vascular ectasia in patients with liver cirrhosis

To determine the efficacy of Argon Plasma Coagulation [APC] in terms of improvement in hemoglobin level and disappearance of telangiectasia as endoscopic treatment for Gastric Antral Vascular Ectasia [GAVE] and Diffuse Antral Vascular Ectasia [DAVE] syndrome in liver cirrhosis. Quasi experimental study. Department of Gastroenterology and Hepatology of Shaikh Zayed Hospital/ Federal Postgraduate Medical Institute, Lahore, from January, 2006 to July, 2007. Cirrhotic patient with gastric vascular ectasia were enrolled and followed-up for 18 months with repeated sessions of APC. Efficacy of APC was evaluated on the basis of patient's symptoms, transfusion requirements and hemoglobin levels. APC was performed by using ERBE generator set at 60 W and flow rate 2.0 L/min using primarily endfiring probes. Fifty patients were enrolled in the study. Mean age was 55.78+1.24 years with 32 males and 18 females giving a male to female ratio 1.7:1. Forty two patients were in Child's Class C and 8 in Child's Class B. Presenting complaints were malena and anemia. Two hundred and fifty three APC sessions were carried out; mean 5.06 + 1.5 sessions per patient. Mean follow-up period after the last session was 8.5 + 3.7 months. Mean increase in the hemoglobin level was 1.35 + 0.24 g/dl. There was no death of any patient during the study period. Treatment with APC is an effective and safe method to decrease blood loss in patients with GAVE and DAVE

Successful treatment of watermelon stomach / GAVE syndrome by using argon plasma coagulation

This case report describes a 50-year-old female patient with liver cirrhosis presented with anemia. She was found to be suffering from gastric antral vascular ectasia [watermelon stomach] on upper gastrointestinal endoscopy. She underwent multiple sessions with Argon plasma coagulation, a non-contact thermal method of hemostasis for the management of watermelon stomach. After 3 sessions, the lesions disappeared and the hemoglobin increased by 2.4 gm/dl without any need of transfusion

Colonoscopic evaluation of middle aged patients with altered bowel habits

To determine the frequency of colorectal carcinoma in patients above 40 years of age presenting with altered bowel habits by colonoscopy. Design: Descriptive study. Place and Duration of Study: Services Hospital, Lahore between August 2000 to August 2002. Patients and A group of 50 consecutive cases presenting with altered bowel habits meeting the inclusion and exclusion criteria were included in the study. History and physical examination were recorded on a specifically designed proforma. Colonoscopy was done in these patients and any abnormality found was reported and biopsy specimen taken and sent for histopathology. A total number of 17 patients presenting with altered bowel habits were found to be suffering from colorectal carcinoma by colonoscopy. Among these in 30% the lesion was in the rectum, in 9% the lesion was in the sigmoid colon, 6% in the descending colon, 4% at the splenic flexure, 5% in the transverse colon, in 16% the lesion was found at the hepatic flexure and in 30% the lesion was in the ascending colon and cecum. Frequency of colorectal carcinoma is high in patients above 40 years of age who presenting with altered bowel habits. They should be investigated preferably by means of colonoscopy which is the most complete method of investigation and diagnostic procedure of choice in patients with a clinical suspicion of colorectal carcinoma