Skip to main content

Main menu

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • Classified ads
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • Classified ads
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Pinterest
  • Follow CMAJ on Youtube
  • Follow CMAJ on Instagram
Practice

Watermelon stomach

Soumya Chatterjee
CMAJ July 15, 2008 179 (2) 162; DOI: https://doi.org/10.1503/cmaj.080461
Soumya Chatterjee MD MS
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Tables
  • Responses
  • Metrics
  • PDF
Loading
  • © 2008 Canadian Medical Association

A 65-year-old man with diffuse systemic sclerosis presented with severe anemia (hemoglobin 50 g/L) and heme in his stool. He had been taking 30 mg of lansoprazole daily for 5 months for symptomatic acid reflux disease. He received 4 units of packed red blood cells. Esophagogastroduodenoscopy revealed gastric antral vascular ectasias (Figure 1), also known as watermelon stomach. A biopsy of the antrum showed loss of epithelial mucin, hypocellular lamina propria, dilated capillary vessels and fibrin thrombi. The vascular ectasias were treated by endoscopic argon plasma coagulation (Figure 2). A total of 3 sessions were performed, 1 per month for 3 months, to ensure complete eradication. The patient's hemoglobin level stabilized at 115 g/L and no additional transfusions were required. He was advised to have an annual esophagogastroduodenoscopy and further coagulation treatments if the ectasias recur.

Figure1
  • Download figure
  • Open in new tab
  • Download powerpoint

Figure 1: Photograph of gastric antral vascular ectasias (watermelon stomach) taken during endoscopy performed on a 65-year-old man.

Figure2
  • Download figure
  • Open in new tab
  • Download powerpoint

Figure 2: Argon plasma coagulation of watermelon stomach.

Watermelon stomach is named for the characteristic longitudinal red columns radiating to the pylorus (Figure 1), visible by endoscopy.1 The condition can occur in patients with systemic sclerosis, portal hypertension and chronic renal failure.2 Submucosal ectatic vessels can erode through the gastric mucosa, leading to chronic loss of blood and substantial iron deficiency anemia. Watermelon stomach is believed to be one of the manifestations of the widespread vasculopathy associated with scleroderma. Histology results show dilated, thrombosed capillaries in the lamina propria and reactive fibromuscular hyperplasia. Conventional therapies for acid-peptic disease are not effective; however, argon plasma coagulation is often successful and is the treatment of choice.2

Footnotes

  • Clinical images are chosen because they are particularly intriguing, classic or dramatic. Submissions of clear, appropriately labelled high-resolution images must be accompanied by a figure caption and the patient's written consent for publication. A brief explanation (300 words maximum) of the educational significance of the images with minimal references is required.

REFERENCES

  1. 1.↵
    Jabbari M, Cherry R, Lough JO, et al. Gastric antral vascular ectasia: the watermelon stomach. Gastroenterology 1984;87:1165-70.
    OpenUrlPubMed
  2. 2.↵
    Novitsky YW, Kercher KW, Czerniach DR, et al. Watermelon stomach: pathophysiology, diagnosis, and management. J Gastrointest Surg 2003;7:652-61.
    OpenUrlCrossRefPubMed
PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 179 (2)
CMAJ
Vol. 179, Issue 2
15 Jul 2008
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Watermelon stomach
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Watermelon stomach
Soumya Chatterjee
CMAJ Jul 2008, 179 (2) 162; DOI: 10.1503/cmaj.080461

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
Watermelon stomach
Soumya Chatterjee
CMAJ Jul 2008, 179 (2) 162; DOI: 10.1503/cmaj.080461
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Footnotes
    • REFERENCES
  • Figures & Tables
  • Responses
  • Metrics
  • PDF

Related Articles

  • Highlights
  • Dans ce numéro
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Azathioprine-induced severe anemia potentiated by the concurrent use of allopurinol
  • Schwannoma of the tongue
  • “Superscan” in diffusion-weighted imaging with background body suppression magnetic resonance imaging
Show more Practice

Similar Articles

Collections

  • Sections
    • Clinical Images
  • Topics
    • Gastroenterology

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions

Copyright 2021, Joule Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

Powered by HighWire