Ectasia vascular antral gastrica (GAVE) / Gastric antral vascular ectasia (GAVE)

La ectasia vascular antral gástrica (GAVE) ha sido reconocida como una de las causas importantes de hemorragia gastrointestinal oculta y oscura. El diagnóstico generalmente se realiza en función de los rasgos endoscópicos característicos, incluida la fila longitudinal de rayas planas y rojizas que irradian desde el píloro hacia el antro que se asemejan a las rayas de una sandía (Watermelon). Estas apariencias, pueden ser fácilmente malinterpretadas como una gastritis de moderada a severa. El diagnóstico del síndrome GAVE en pacientes con enfermedad renal o hepática suele ser problemático porque hay causas más frecuentes de hemorragia gastrointestinal en estas enfermedades como, por ejemplo, malformaciones vasculares, enfermedad ulcerosa péptica, várices esofágicas o gástricas y úlceras colónicas y rectales que eclipsan al síndrome GAVE. Creemos que el tratamiento quirúrgico es una modalidad cuando los diferentes métodos, no pudieron tratar de solucionar esta patología del GAVE. Probablemente en nuestro medio necesitamos más sospecha clínica de esta patología, como así mismo mayor experiencia en los tratamientos endoscópicos de tipo terapéuticos. Ante la falla de estos métodos, la cirugía , ya sea laparoscópica o convencional siguen teniendo lugar en la resolución de estos pacientes con patología poco común.

Gastric antral vascular ectasia (Gave) has been recognized as one of the important causes of hidden and dark gastrointestinal hemorrhage. The diagnosis is generally performed based on the characteristic endoscopic features, including the longitudinal row of flat and reddish stripes that radiate from the pylorus to the antrum that resemble the stripes of a watermelon (watermelon). These appearances can be easily misunderstood as moderate to severe gastritis. The diagnosis of the Gave syndrome in patients with renal or hepatic disease is usually problematic because there are more frequent causes of gastrointestinal bleeding in these diseases such as vascular malformations, peptic ulcerative disease, esophageal or gastric veins and colonic and rectal ulcers that eclipsan al Gave syndrome. We believe that surgical treatment is a modality when the different methods could not try to solve this pathology of the Gave. Probably in our environment we need more clinical suspicion of this pathology, as well as more experience in therapeutic endoscopic treatments. Given the failure of these methods, surgery, whether laparoscopic or conventional continue to take place in the resolution of these patients with unusual pathology.

Endoscopic Features of Upper Gastrointestinal Tract in Patients with Systemic Sclerosis Compared to the Healthy Control

OBJECTIVE: To characterize the endoscopic features of upper gastrointestinal tract in patients with systemic sclerosis (SSc) compared with those in the healthy controls. METHODS: Data on esophagogastroduodenoscopy (EGD) in 180 patients with SSc (SSc group) were compared with that from the 181 age- and sex-matched healthy control who underwent EGD for routine check-up (control group). Clinical data of participants at the time of EGD (defined as baseline) were collected from electric medical record. Endoscopic findings were evaluated by two experts with blinded to their clinical features. Primary outcome of the study was prevalence of each endoscopic lesion between the two groups. RESULTS: The mean±standard deviation age and disease duration in the SSc group at baseline were 55.3±11.8 and 2.9±3.7 years, respectively. Compared to the control group, SSc group more frequently showed reflux esophagitis (32.8% vs. 9.4%, p < 0.001). In contrast, prevalence of atrophic gastritis was significantly lower in the SSc group (8.3% vs. 29.3%, p < 0.001). This result was consistent in the multivariable analysis where patients' age and concomitant proton pump inhibitor use were adjusted. There was no case of gastric antral vascular ectasia (GAVE) in both groups. However, 29 (16.1%) patients in SSc group showed a clinically significant anemia (hemoglobin < 10 mg/dL), with none of the endoscopic features showed significant associations with the outcome. CONCLUSION: Patients with SSc showed significantly lower prevalence of atrophic gastritis. There was no case of GAVE, which suggests that clinical phenotype of the SSc could be different according to the ethnicity or geographic region.

Elevated Gastric Antrum Erosions in Portal Hypertension Patients: Peptic Disease or Mucosal Congestion? / 대한소화기학회지

BACKGROUND/AIMS: Portal hypertension (PH) is a syndrome characterized by chronic increase in the pressure gradient between the portal vein and inferior vena cava. Previous studies have suggested an increased frequency of antral elevated erosive gastritis in patients with PH, as well as an etiologic association; however, there has not been any histological evidence of this hypothesis to date. Our aim was to evaluate the histological features found in elevated antral erosions in patients with portal hypertension. METHODS: Sixty-nine patients were included; 28 with and 41 without PH. All patients underwent endoscopy, and areas with elevated antral erosion were biopsied. RESULTS: In the PH group, 24 patients had inflammatory infiltration with or without edema and vascular congestion, and 4 patients had no inflammation. In the group without PH, all patients showed inflammatory infiltration of variable intensity. There was no statistical significance between the two groups in the presence of Helicobacter pylori. There as a histological similarity between the two groups, if PH patients without inflammation were excluded; however, more edema and vascular congestion were observed in the PH group (p=0.002). CONCLUSIONS: The findings show that elevated antral erosions in patients with PH have more evident edema and vascular congestion in addition to lymphocytic infiltration.

Alternativas terapéuticas para el manejo de la ectasia vascular gástrica antral (GAVE) / Alternatives for the treatment of gastric antral vascular ectasia (GAVE)

Gastric antral vascular ectasia is an unusual cause of upper gastrointestinal bleeding. The most frequent clinical presentation is iron deficiency anemia in a female patient older than 60 years. A third of patients have liver cirrhosis or a connective tissue disease, especially those related to Raynaud’s syndrome and scleroderma. The severity of this condition is variable, in some cases iron supplements are enough, while in other transfusion requirements are permanent. Currently the therapies most frequently reported in literature are argon plasma coagulation, radiofrequency ablation and endoscopic band ligation of antral mucosa. This article aims to review the available evidence for the management of this condition.

La ectasia vascular gástrica antral es una causa infrecuente de hemorragia digestiva alta cuya forma de presentación más habitual es la anemia ferropriva en una mujer mayor de 60 años. Un tercio de los pacientes tiene antecedente de cirrosis hepática o enfermedades del tejido conectivo relacionadas al síndrome de Raynaud o esclerodermia. El compromiso es de intensidad variable, sin embargo, en casos graves los pacientes pueden requerir transfusiones en forma permanente. En la actualidad las terapias más frecuentemente reportadas en la literatura son la termocoagulación con argón plasma, la ablación con radiofrecuencia y la ligadura de mucosa antral con bandas elásticas. El objetivo principal de este artículo es revisar la evidencia disponible para el manejo de esta condición.

Erythropoietin resistance in end-stage renal disease patient with gastric antral vascular ectasia / Resistência à eritropoetina em paciente com IRC e ectasia vascular gástrica

Abstract We observed a case of recombinant human erythropoietin resistance caused by Gastric Antral Vascular Ectasia in a 40-year-old female with ESRD on hemodialysis. Some associated factors such as autoimmune disease, hemolysis, heart and liver disease were discarded on physical examination and complementary tests. The diagnosis is based on the clinical history and endoscopic appearance of watermelon stomach. The histologic findings are fibromuscular proliferation and capillary ectasia with microvascular thrombosis of the lamina propria. However, these histologic findings are not necessary to confirm the diagnosis. Gastric Antral Vascular Ectasia is a serious condition and should be considered in ESRD patients on hemodialysis with anemia and resistance to recombinant human erythropoietin because GAVE is potentially curable with specific endoscopic treatment method or through surgical procedure.

Resumo Observou-se um caso de resistência à eritropoetina recombinante humana causada por Ectasia Vascular Antral Gástrica em uma mulher de 40 anos de idade, com doença renal terminal em hemodiálise. Alguns fatores associados, tais como a doença autoimune, hemólise, doenças cardíacas e hepáticas foram descartados no exame físico e exames complementares. O diagnóstico é baseado na história clínica e aspecto endoscópico de estômago em melancia. Os achados histológicos são proliferação fibromuscular e ectasia capilar com trombose microvascular da lâmina própria. No entanto, esses achados histológicos não são necessários para confirmar o diagnóstico. Ectasia Vascular Antral Gástrica é uma condição séria e deve ser considerada em pacientes com insuficiência renal terminal em hemodiálise com anemia refratária e resistência à eritropoetina humana recombinante porque é potencialmente curável com o método de tratamento endoscópico específico ou através de procedimento cirúrgico.

Management of portal hypertensive gastropathy and other bleeding

A major cause of cirrhosis related morbidity and mortality is the development of variceal bleeding, a direct consequence of portal hypertension. Less common causes of gastrointestinal bleeding are peptic ulcers, malignancy, angiodysplasia, etc. Upper gastrointestinal bleeding has been classified according to the presence of a variceal or non-variceal bleeding. Although non-variceal gastrointestinal bleeding is not common in cirrhotic patients, gastroduodenal ulcers may develop as often as non-cirrhotic patients. Ulcers in cirrhotic patients may be more severe and less frequently associated with chronic intake of non-steroidal anti-inflammatory drugs, and may require more frequently endoscopic treatment. Portal hypertensive gastropathy (PHG) refers to changes in the mucosa of the stomach in patients with portal hypertension. Patients with portal hypertension may experience bleeding from the stomach, and pharmacologic or radiologic interventional procedure may be useful in preventing re-bleeding from PHG. Gastric antral vascular ectasia (GAVE) seems to be different disease entity from PHG, and endoscopic ablation can be the first-line treatment.

Enteroscopía doble balón en el manejo de enfermedades del intestino delgado: experiencia inicial en el Hospital Nacional Guillermo Almenara Irigoyen. Lima - Perú / Enteroscopia double balloon in the management of diseases of the small intestine: initial experience in the National Hospital Guillermo Almenara Irigoyen. Lima - Peru

OBJETIVO: Evaluar la utilidad diagnostica y terapéutica, seguridad, eficacia y complicaciones de enteroscopia de doble balón (EDB). MATERIAL Y METODOS: Es un estudio descriptivo prospectivo. Se realizó en el Servicio de Gastroenterología del Hospital Guillermo Almenara Irigoyen Lima-Perú. El estudio comprendió de Julio 2010 a Noviembre 2011.Se practicaron 33 exámenes en 30 pacientes bajo sedación consciente y con preparación previa. Se utilizó un enteroscopio de doble balón EN-450T5 Fujinon. Los pacientes firmaron un consentimiento informado antes del examen. RESULTADOS: La hemoglobina promedio fue 9.16 gr/dl. Se realizaron capsula endoscópica previamente en 16 pacientes (53%). La indicación más frecuente fue la hemorragia digestiva de origen oscuro (70%). La vía de abordaje más utilizada fue la anterógrada (66.7%). La distancia máxima alcanzada fue de 206 cm vía oral. El tiempo promedio de duración fue de 137 min. Las Ectasias vasculares son los hallazgos más frecuentes. El rendimiento diagnostico fue 57.6%, similar a otras series. La utilidad terapéutica fue de 45.4%. El procedimiento terapéutico más usado fue la aplicación de argón plasma. Al igual que otras series, los pacientes toleraron la EDB muy bien, con la incomodidad transitoria y sin mayores complicaciones. CONCLUSIONES: La EDB se ha mostrado como una técnica segura, útil y eficaz para el diagnostico y tratamiento de las enfermedades del intestino delgado, sobre todo en la hemorragia digestiva de origen oscuro.

OBJECTIVE: Evaluate the diagnostic and therapeutic utility, safeness, efficacy and complications of double ballon enteroscopy (DBE). METHODS: This rpospective, descriptive study of DBE took place between July 2010 and November 2011 at Gastroenterology Service of Hospital Nacional Guillermo Almenara Irigoyen-EsSaLUD. 33 DBE were performed in 30 patients with a double ballon enteroscope: EN-450T5 Fujinon, under conscious sedation and with previous bowel preparation. All of them signed an informed consent. RESULTS: The mean hemoglobin was 9.16gr./dl. 16 patients (53%) had capsule endoscopy previous to the exam. The most frequent indication dor DBE was gastrointestinal bleeding of obscure origin. The per-oral route was used in 66.7% of the cases reaching a maximum distance of 206 cm. The mean examination time was 137 minutes. The most frequent finding was vascular ectasia. The diagnostic yield was 57.6% (similar to other published series). The therapeutic usefulness is equal to 45.4%. The therapeuthic procedure most used was argon beanm plasma (ABP). As a published by other authors the exam was well tolerated by all patients with no complications after the procedure. CONCLUSIONS: DBE is a secure, useful and effcient technique for the exploration and treatment of small bowel disease, mainly in the cases of gastrointestinal bleeding of unknown origin.

Ligadura endoscópica, una nueva opción terapéutica para la ectasia vascular antral: presentación de dos casos clínicos / Endoscopic band ligation, for gastric antral vascular ectasia: Report of two cases

Gastric antral vascular ectasia is an uncommon cause of chronic anemia, occasionally associated with cirrhosis. The most accepted therapy is argon plasma coagulation (APC), however there are refractory cases. We report two females with cirrhosis, aged 60 and 72 years, in whom management with APC was insufficient and in whom the need for hospital admissions and transfusions were reduced using the technique of endoscopic band ligation.

Estômago em melancia / Watermelon stomach

Estômago em melancia ou ectasia vascular gástrica é rara causa de hemorragia gastrointestinal alta e anemia ferropriva, sendo responsável por 1,2% a 8% das hemorragias digestivas. Relatamos o caso de uma paciente do sexo feminino, idosa, que apresentava anemia ferropriva crônica, com frequentes hemotransfusões, sendo diagnosticada ectasia vascular antral e realizado tratamento endoscópico com eletrocoagulação com argônio. Foi realizada uma eletrocoagulação com argônio, havendo regressão endoscópica das lesões e resolução da anemia da paciente.

Watermelon stomach or gastric vascular ectasia is a rare cause of upper gastrointestinal hemorrhage and iron deficiency anemia account for 1.2-8% of all gastrointestinal bleeding. We report a case of elderly female patient with cronic iron deficiency anemia requiring frequents hemotransfusions. We diagnostic gastric vascular ectasia and realized endoscopic treatment with argon plasma coagulation with regression of injuries and anemia resolution.

Consideraciones actuales de la gastropatía hipertensiva portal / Current considerations of portal hypertensive gastropathy

La gastropatía hipertensiva portal puede ser causa de hemorragia digestiva, aguda o crónica, en pacientes con hipertensión portal. Objetivo: profundizar en la gastropatía hipertensiva portal y su importancia para gastroenterólogos, clínicos, cirujanos, patólogos y médicos en general. Desarrollo: se presenta una revisión bibliográfica actualizada sobre los principales aspectos clínicos, endoscópicos, histológicos y terapéuticos de la enfermedad; así como su patogenia, prevalencia e historia natural de la misma. Además, se analizan las formas de enfrentar esta enfermedad y se hace hincapié en las interrogantes y retos que plantean los nuevos conocimientos. Se especifican los aspectos más novedosos en cuanto al manejo; se presta especial atención al diagnóstico y la terapéutica endoscópica. Conclusiones: la posibilidad de un sangrado a partir de una gastropatía portal hipertensiva es un hecho a tomar en cuenta. El tratamiento con propanolol es de gran utilidad en la prevención del sangramiento inicial y recurrente.

Portal hypertensive gastropathy may be cause digestive, acute or chronic hemorrhage, in patients with portal hypertension. Objective: to deepen in portal hypertensive gastropathy and its importance for gastroenterologists, clinicians, surgeons, pathologists and doctors in general. Development: an update bibliographical review is presented on the main clinical, endoscopic, histological and therapeutic aspects of the disease; as well as its pathogeny, prevalence and natural history. The ways of facing this disease and special emphasis is made in the questions and challenges that exposed the new knowledge also are analyzed. The most novel aspects as for the handling are specified; special attention is paid to the diagnosis and to the endoscopic therapy. Conclusions: the possibility of a bleeding starting from a portal hypertensive gastropathy it is a fact to take into account. The treatment with propanolol is very useful in the prevention of the initial and recurrent bleeding.

Experiencia con argón plasma en lesiones del tracto gastrointestinal en dos instituciones de Bogotá / Experience in the use of argon plasma in gastrointestinal tract lesions in two institutions in Bogotá

La terapia de coagulación con argón plasma (APC) ha tomado importancia en la última década en la endoscopia gastrointestinal, y está posicionada como una técnica efectiva en el tratamiento de lesiones del tracto digestivo. Su efectividad fue inicialmente reportada en el tratamiento paliativo de neoplasias gastrointestinales y, posteriormente, su uso se ha extendido para múltiples indicaciones, entre ellas el tratamiento de sangrado debido a angiodisplasias, proctitis por radioterapia y hoy en día es utilizada para control de hemorragia gastrointestinal en lesiones vasculares como Dieulafoy. En la actualidad su uso se ha extendido, con el advenimiento de la enteroscopia, a lesiones del intestino delgado en especial las angioectasias. En este estudio se describe la experiencia de dos instituciones con el uso endoscópico del APC, y se exponen las indicaciones y efectividad del tratamiento. Métodos: Entre noviembre del 2007 y abril del 2009, la terapia con argón plasma se utilizó para el tratamiento de 65 pacientes con patologías del tracto digestivo con fin terapéutico, ya fuera curativo o paliativo con un total de 134 sesiones. El tratamiento se efectuó en dos centros de cuarto nivel de atención, el Hospital Universitario San Ignacio y la Clínica de Marly en Bogotá - Colombia. Resultados: El tratamiento con APC se realizó en 65 pacientes, utilizando en total 134 sesiones de argón. Las indicaciones para su uso son similares a las reportadas en la literatura: proctitis actínica, angiodisplasias, ectasia vascular antral y control de sangrado por lesiones tumorales. Se utilizó además en control de sangrado por lesión vascular de Dieulafoy y en el control de hemorragia por úlcera péptica sangrante con vaso expuesto. No se presentaron complicaciones mayores, lo que respalda lo expuesto en la literatura en relación a que es una técnica efectiva y segura para el manejo de diversas patologías del tracto digestivo.Conclusiones: La experiencia recogida en este estudio descriptivo demuestra el posicionamiento de la técnica del APC en nuestro medio, con una amplia gama de indicaciones sobre patologías del tracto digestivo y un excelente margen de efectividad y seguridad. Si se tienen presentes las indicaciones y recomendaciones para su aplicación, el uso del argón es una técnica sencilla, útil y efectiva.

In the last decade Argon Plasma Coagulation therapy (APC) has become important in gastrointestinal endoscopy. It is regarded as an effective technique in the treatment of lesions in the gastrointestinal tract. Its effectiveness was initially reported in the palliative treatment of gastrointestinal neoplasm, but its use has subsequently been extended to multiple indications such as treatment of bleeding angiodysplastic lesions, proctitis via radiotherapy and for gastrointestinal hemorrhage control of lesions such as Dieulafoy’s lesion. With the advent of enteroscopy its use has been extended to small intestinal lesions, especially to Angioectasias. This study describes indications and effectiveness of treatment in the experience of two institutions that make endoscopic use of APC.Methods: Between November, 2007 and April, 2009 Argon Plasma therapy was used in a total of 134 sessions for either curative or palliative treatment of 65 patients with digestive tract pathologies. Treatments were performed in two level four attention centers, the San Ignacio University Hospital and the Marly Clinic, both located in Bogotá, Colombia. Results: 65 patients received APC treatment in a total of 134 sessions. Indications for its use were similar to those reported in the literature: actinic proctitis, angiodysplasia, antral vascular ectasia and control of bleeding due to tumoral lesions. It was also used to control bleeding from vascular lesions such as Dieulafoy’s lesion and for hemorrhage control for bleeding peptic ulcers with exposed vessels. The absence of greater higher complications validates reports in the literature that this is a safe and effective technique for management of several digestive tract pathologies. Conclusions: The experience collected in this descriptive study shows that the addition of the APC technique in our environment provides a high range of indications about digestive tract pathologies with good effectiveness and safety margin. Reasonable use of Argon Plasma Coagulation therapy (APC), keeping in mind indications and recommendations for its application, is a simple, useful and effective technique

Chronic anemia due to watermelon stomach

Antral gastric vascular ectasia is a rare cause of chronic anemia. When encountered, the diagnosis is usually delayed. Endoscopic findings are well established, although radiologic findings are not. Patients respond well to surgery. Our case was of a 62-year-old female with chronic anemia who required multiple blood transfusions and iron replacement therapy, without significant response. Computed tomography revealed a focal thickening of the gastric antrum. Endoscopy showed vascular ectasia between the antrum and corpus. The patient underwent gastrectomy. We reviewed the literature on gastric angiodysplasia and have presented our unique tomography findings in this first report on a novel association between ectopic pancreas and gastric angiodysplasia

Portal Hypertensive Gastropathy and Gastric Antral Vascular Ectasia / 대한소화기학회지

Portal hypertensive gastropathy (PHG) is a term used to define the endoscopic findings of gastric mucosa with a characteristic mosaic-like pattern with or without red spots, and a common finding in patients with portal hypertension. These endoscopic findings correspond to dilated mucosal capillaries without inflammation. The pathogenesis of PHG in not well known, but portal hypertension and some humoral factors seem to be crucial factors for its development. Pharmacological (e.g. propranolol), or interventional radiological (such as transjugular intrahepatic portosystemic shunt) procedures may be useful in preventing re-bleeding from PHG. The classic features of gastric antral vascular ectasia (GAVE) syndrome include red, often haemorrhagic lesions predominantly located in the gastric antrum which can result in significant blood loss. Although the pathogenesis of GAVE is not clearly defined, it seems to be a separate disease entity from PHG, because GAVE generally does not respond to a reduction of portal pressures. Endoscopic ablation (such as argon plasma coagulation) is the first-line treatment of choice. This review will focus on the incidence, clinical importance, etiology, pathophysiology, and treatment of PHG and GAVE syndrome in the setting of portal hypertension.

Hemorragia gastrointestinal de grande vulto diagnosticada por enteroscopia intraoperatória: relato de caso / Contribution for the diagnosis of severe gastrointestinal bleeding by intraoperative enteroscopy: a case report

Aproximadamente 5% dos pacientes com hemorragia digestiva ficam sem diagnóstico e uma parcela deles tem como fator etiológico doenças do intestino delgado. Os autores relatam caso de homem de 60 anos de idade, portador de angiectasia de jejuno, diagnosticada somente quando submetido a enteroscopia peroperatória durante episódio hemorrágico. Ressecção de 30 cm de jejuno com base na presença de sangue na luz intestinal, teve o diagnóstico confirmado somente com exame histopatológico, pois a lesão não era visível a olho nu. Um ano após a ressecção o paciente permanecia assintomático e sem anemia.

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

Surgical Therapy for Annuloaortic Ectasia with David Procedure

N.A.

Two Cases of Rectal Vascular Ectasia in Patients with Liver Cirrhosis and Who Were Treated by Argon Plasma Coagulation / 대한소화기내시경학회지

The term "vascular ectasia" is defined to include angiodysplasia, gastric antral vascular ectasia (GAVE) and telangiectasis, and these are the leading causes of acute or chronic gastrointestinal bleeding. We describe here the first 2 Korean cases of GAVE with rectal vascular ectasia in patients with liver cirrhosis. A 70-year-old woman was admitted to the hospital with hematochezia. The finding on endoscopy showed diffuse nonconfluent spots with oozing bleeding on the antrum and several vascular spots with oozing bleeding on the rectum. The lesions were successfully treated by argon plasma coagulation (APC). We report on another case of rectal vascular ectasia in a patient with liver cirrhosis. A 77-year-old man was admitted to the hospital with hematochezia. The findings on colonoscopy showed diffuse vascular spots with oozing bleeding on the rectum. The lesions were successfully treated by APC. These two patients have had no bleeding since their treatment, and they are currently being evaluated by follow-up studies at the outpatient department.