Gastroenterologie
a hepatologie

Endoskopická a medikamentózní terapie cévních ektázií žaludečního antra (GAVE): série kazuistik a přehled metod

Michaela Šramková¹, Lumír Kunovský¹, Jiří Dolina¹, Štefan Konečný¹, Radek Kroupa¹, Milan Dastych¹

+ Pracoviště
¹ Department of Gastroenterology and Internal Medicine, University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic

Souhrn

Cévní ektázie žaludečního antra (GAVE – gastric antral vascular ectasia) je vzácná dia­gnóza, která může vést ke chronické sideropenické anemii v důsledku okultního nebo zjevného krvácení do gastrointestinálního traktu. Za základ léčby GAVE jsou považovány endoskopické termické metody – z nichž nejužívanější je argon-plazma koagulace, dále radiofrekvenční ablace nebo kryoterapie. Příznivé výsledky jsou publikovány také v souvislosti s používáním endoskopické ligace. V případě GAVE refrakterní na předchozí endoskopickou léčbu lze použít farmakoterapii, jejíž podstatou je redukce tvorby cévních malformací a krevního průtoku v nich. Prezentujeme přehled dostupných endoskopických a neendoskopických metod pro léčbu GAVE a naše zkušenosti s léčbou refrakterní GAVE kombinací endoskopických metod a thalidomidu formou kazuistik. Navrhujeme možný algoritmus pro terapii GAVE.

Klíčová slova

gastric antral vascular ectasia, argon plasma coagulation, endoscopic band ligation, thalidomide, gastrointestinal bleeding

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