Watermelon stomach - An unusual cause of recurrent upper gastrointestinal bleeding in a uremic patient receiving estrogen- progesterone therapy: Case report

C. C. Chien, J. T. Fang*, C. C. Huang

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

5 Scopus citations

Abstract

A 50-year-old woman who had been on maintenance hemodialysis for 5 years developed severe anemia resistant to treatment with iron supplements and erythropoietin 4 months prior to hospital admission. Her stool occult blood test was positive, and an initial panendoscopy revealed evidence of possible antral gastritis. However, repeated administration of sucralfate, H2 blockers and a proton pump inhibitor was not effective in preventing further gastrointestinal tract blood loss and subsequent refractory anemia. She required multiple blood transfusions and hospital admissions during this period. There was no obvious coagulopathy or thrombocytopenia. After her third admission, a second panendoscopy demonstrated the typical picture of watermelon stomach. A trial of hormone therapy with estrogen and progesterone increased the hemoglobin level within a month without further evidence of active gastrointestinal bleeding. From our experience with this case, we found that the diagnosis of antral vascular ectasia (watermelon stomach) with bleeding requires a high degree of clinical alertness and careful endoscopic examination. Estrogen and progesterone therapy may provide a good option for treating the disease in uremic patients without an obvious complication. To the best of our knowledge, this is the first report demonstrating the use of maintenance hormone therapy in a female uremic patient to successfully treat watermelon gastric bleeding.

Original languageEnglish
Pages (from-to)458-462
Number of pages5
JournalChang Gung Medical Journal
Volume21
Issue number4
StatePublished - 1998
Externally publishedYes

Keywords

  • Estrogen- progesterone therapy
  • GI bleeding
  • Hemodialysis
  • Osteoporosis
  • Vascular ectasia
  • Watermelon stomach

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