Watermelon stomach as first symptom of liver cirrhosis- case report and literature review

Gastric antral vascular ectasia (GAVE), so-called watermelon stomach, is uncommon cause of refractory gastrointestinal bleeding  or iron deficiency anemia with unclear etiology. GAVE is associated with a number of conditions such as portal hypertension, chronic kidney disease and collagen vascular diseases. Most commonly GAVE is diagnosed during gastroscopy. Red antral stripes radiating in linear arrays in the antrum are the most characteristic endoscopic feature. Furthermore clinical course and histological changes are equally important in the diagnostic process . The treatment of GAVE is based on medical, endoscopical and surgical methods. We present an unusual case of GAVE which was a first symptom of liver cirrhosis detected intraoperatively during gastrict resection because of recurrent blood loss. The liver biopsy was taken what confirmed the diagnosis. Before the surgery numerous laboratory tests, computed tomography scan, abdomen ultrasound were performed which did not indicate liver disease.