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Endoscopy 2004; 36(1): 68-72
DOI: 10.1055/s-2004-814112
Original Article
© Georg Thieme Verlag Stuttgart · New York

Endoscopic Treatment Outcomes in Watermelon Stomach Patients with and without Portal Hypertension

G.  S.  Dulai1 , D.  M.  Jensen1 , T.  O.  G.  Kovacs1 , I.  M.  Gralnek1 , R.  Jutabha1
  • 1Center for Ulcer Research and Education, Digestive Disease Research Center, Center for the Study of Digestive Healthcare Quality and Outcomes, University of California at Los Angeles School of Medicine and Veterans’ Administration Greater Los Angeles Healthcare System, Los Angeles, California, USA
Further Information

Publication History

Submitted 9 September 2002

Accepted after Revision 15 July 2003

Publication Date:
14 January 2004 (online)

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Background and Study Aims: Watermelon stomach is a source of recurrent gastrointestinal hemorrhage and anemia. The aims of this study were to describe the endoscopic appearance and treatment outcomes in watermelon stomach patients with and without portal hypertension.
Patients and Methods: All patients with watermelon stomach enrolled in a hemostasis research group’s prospective studies from 1991 to 1999 were identified. Investigators collected data using standardized forms. Comparisons were made using the chi-squared test, Wilcoxon rank-sum test, and Wilcoxon signed-rank test.
Results: Twenty-six of 744 (4 %) consecutively enrolled patients with nonvariceal upper gastrointestinal hemorrhage had watermelon stomach as the cause. Eight of these 26 patients (31 %) also had portal hypertension. These patients had diffuse antral angiomas, as opposed to the classic linear arrays seen in those without portal hypertension. The demographic data and clinical presentations of the two groups were otherwise similar. Palliative endoscopic treatment was associated with a significant rise in hematocrit and a decrease in the need for blood transfusion or hospitalization in watermelon stomach patients with and without portal hypertension.
Conclusions: Watermelon stomach patients with and without portal hypertension had similar clinical presentations. The endoscopic findings differed in that those with portal hypertension had more diffuse gastric angiomas. Bleeding was effectively palliated by endoscopic treatment, regardless of the presence of portal hypertension.

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G. S. Dulai, M. D., M.S.H.S.

VA Greater Los Angeles Healthcare System · CURE Digestive Diseases Research Center, Building 115, Room 215c

11301 Wilshire Boulevard · Los Angeles, CA 90073 · USA

Fax: + 1-310-794-2908

Email: gdulai@mednet.ucla.edu

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