A 71-year-old man with cirrhosis was admitted with melena. Upper endoscopy showed
diffuse capillary dilation and redness in the antrum, and a diagnosis of diffuse antral
vascular ectasia was made (A). EUS with a 20 MHz US catheter probe performed under constant filling of deaerated
water in the stomach demonstrated marked thickening of the second and third sonographic
layers (mucosa and submucosa, respectively) as well as small hypoechoic spaces within
these layers (B; arrow, submucosa; arrowheads, muscularis propria). The vascular lesions were treated by argon plasma coagulation
without complication. Tests for fecal occult blood reverted to negative. Upper endoscopy
7 weeks later revealed disappearance of the dilated capillaries and no cicatricial
narrowing of the pylorus (C). EUS also demonstrated disappearance of the luminal structures in the second and
third sonographic layers and no evidence of injury to the fourth sonographic layer,
the muscularis propria (D; arrow, submucosa; arrowheads, muscularis propria). The patient had no further bleeding.
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© 2001 Published by Elsevier Inc. All rights reserved.
