Radiofrequency ablation using Barrx® for the endoscopic treatment of gastric antral vascular ectasia: a series of three cases and a review of the literature on treatment options

Anish Patel, Sunil Patel, Prasanna C Wickremesinghe, Deepak Vadada Department of Gastrointestinal Medicine, Richmond University Medical Center, Staten Island, NY, USA Abstract: Gastric antral vascular ectasia (GAVE), also known as “watermelon stomach”, is an uncommon condition, which can cause gastrointestinal bleeding due to rupture of blood vessels that line the stomach. The pathogenesis of GAVE remains unclear; however it is thought that hemodynamic changes, mechanical stress, and autoimmune factors all have a part to play. A range of conditions are also commonly associated with the syndrome, such as portal hypertensive gastropathy, liver cirrhosis, and autoimmune disorders. Less commonly, chronic renal failure, cardiac diseases, and bone marrow transplantation have coexisted with GAVE. The diagnosis is usually based on visualization of the tissue upon endoscopy; however, histology plays a role in uncertain cases. The typical “watermelon” appearance relates to the tissue having a striped appearance radiating out from the pylorus. Medical treatment has failed to show satisfactory results and surgery is usually considered as a last resort, due to its increased risk for complications and mortality. Lasers and argon plasma coagulation have been used recently, and been shown to be as effective as surgery and a safer option. We present three cases of gastric antral vascular ectasia treated at our institution with radiofrequency ablation and review the literature on treatment modalities for GAVE. Keywords: gastric antral vascular ectasia, radiofrequency ablation, Barrx, endoscopic treatmen

Radiofrequency ablation using BarRx for the endoscopic treatment of radiation proctopathy: a series of three cases

Anish Patel, Rahul Pathak, Vrushak Deshpande, Sunil H Patel, Prasanna C Wickremesinghe, Deepak Vadada Department of Gastrointestinal Medicine, Richmond University Medical Center, Staten Island, NY, USA Abstract: Radiation proctopathy is a complication of pelvic radiotherapy, which occurs in patients treated for carcinoma of the prostate, rectum, urinary bladder, cervix, uterus, and testes. If it presents within 6 weeks to 9 months after therapy, it is called acute radiation proctitis/proctopathy (ARP), and if it occurs 9 months to a year after treatment, it is classified as chronic radiation proctitis/proctopathy (CRP). CRP occurs in 5%–20% of patients receiving pelvic radiation, depending on the radiation dose and the presence or absence of chemotherapy. In many cases, CRP resolves spontaneously, but in some, it can lead to persistent rectal bleeding. Other symptoms of CRP include diarrhea, mucoid discharge, urgency, tenesmus, rectal pain, and fecal incontinence. Despite the availability of several therapies, many patients fail to respond, and continue to suffer in their quality of life. Radiofrequency ablation (RFA) is a newer endoscopic technique that uses radiofrequency energy to ablate tissue. This is an emerging way to treat radiation proctopathy and other mucosal telangiectasia. We present three cases of radiation proctopathy treated with RFA at our institute and review the literature on treatment modalities for CRP. We were also able to find 16 other cases of CRP that used RFA, and review their literature as well as literature on other treatment modalities. Keywords: radiofrequency ablation, radiation proctopathy, BarRx, Halo cathete

За кадры. 1976. № 38 (1956)

Пятилетка Вали Ростовцевой / С. ХабибулинПеред практикой / С. КошиковаНе только наша забота / В. ВысоцкаяЗеркало знанийЛекции преподавателейСлово партии - в жизнь / [беседа с] М. С. Ройтман ; [беседа с] А. А. СеливановаВ месткоме ТПИПартийная группа на кафедре / Р. ГорскаяЕсть второе классное / А. ПортнягинЗапах солнца / А. ЧигоркоЗагадка для компьютера / Е. ЗагданскийЧемпионы определены / Л. ДроздовБудем танцевать. Твое свободное время / [беседа с] Ш. Халитов ; [беседа с] Г. КосенюкПомощь совхозу / О. Николаев