Vnitr Lek 2017, 63(5):339-342 | DOI: 10.36290/vnl.2017.068

Gastric antral vascular ectasia and solitary rectal ulcer syndrome - two rare diagnoses as the cause of anemia in a single patient: case report

Lumir Kunovsky^1,2,*, Milan Dastych¹, Radek Kroupa¹, Beata Hemmelova², Katarina Muckova³, Miroslava Chovancova³, Lenka Kucerova¹, Jiri Dolina¹

¹ Department of Gastroenterology, Faculty of Medicine, Masaryk University, University Hospital Brno Bohunice, Czech Republic

² Department of Surgery, Faculty of Medicine, Masaryk University, University Hospital Brno Bohunice, Czech Republic

³ Department of Pathology, Faculty of Medicine, Masaryk University, University Hospital Brno Bohunice, Czech Republic

Gastric antral vascular ectasia (GAVE) and solitary rectal ulcer syndrome (SRUS) are both mentioned in the literature as rare causes of iron deficiency anemia and gastrointestinal (GI) bleeding. GAVE accounts for up to 4 % of upper non-variceal GI bleeding; SRUS is a rare benign disorder that presents with rectal bleeding. We present the case of a 75-year-old patient who was admitted to our facility with anemia. In the same patient, we encountered chronic bleeding from GAVE and SRUS. Both diagnoses were treated endoscopically: GAVE by argon plasma coagulation and a subsequent treatment with proton pump inhibitors and SRUS by adrenaline injection and clipping, consecutively treated with mesalazine enemas. The patient was successfully cured, resulting in a stable level of hemoglobin and no recurrent GI bleeding. We report a unique case of chronic GI bleeding caused by two uncommon diagnoses. The co-occurrence of GAVE and SRUS has not been previously described or published.

Keywords: anemia; endoscopy; gastric antral vascular ectasia (GAVE); gastrointestinal bleeding; solitary rectal ulcer syndrome (SRUS)

Received: March 25, 2017; Accepted: April 28, 2017; Published: May 1, 2017  Show citation