The misclassification of gastric antral vascular ectasia.

Academic Article

Abstract

  • BACKGROUND: Gastric antral vascular ectasia (GAVE) is characterized by angiodysplastic lesions and is a rare form of gastrointestinal bleeding. Given the multiple patterns, GAVE can be misclassified. AIM: We analyzed the misclassification of GAVE among patients undergoing esophagogastroduodenoscopy (EGD). METHODS: We performed a retrospective review of 941 EGDs between 2017 and 2019. Inclusion criteria included findings of GAVE on EGD┬▒biopsy. Correct classification was based on visual EGD findings. Outcome variables included misclassification rate, endoscopist's background, and concordance between EGD and pathology. Cohen's Kappa test was used for concordance analysis. RESULTS: A total of 110 patients had EGD findings of GAVE with a corresponding 184 EGDs. The misclassification rate among EGDs was 74/184 (40%). Furthermore, 81/110 patients were correctly classified with their first workup, whereas 29/110 patients needed repeat testing. In cases of misclassification, GAVE was mostly referred to as erythema (43%), with ulceration, gastritis, or polyps. Sixty-six (60%) patients had biopsies with a concordance of 76% between EGD and biopsy (╬║=0.35). CONCLUSIONS: Our findings indicate GAVE was misclassified up to 40% on EGDs with hepatologists and gastroenterologists having similar misclassification rates. Proper identification is crucial given susceptibility to upper gastrointestinal bleeding. RELEVANCE FOR PATIENTS: This study emphasizes the importance of accurate classification of GAVE to ensure proper treatment of these lesions which can improve clinical outcomes.
  • Authors

    Keywords

  • biopsy, endoscopy, gastric antral vascular ectasia, misdiagnosis, watermelon stomach
  • Author List

  • Aryan M; Jariwala R; Alkurdi B; Peter S; Shoreibah M
  • Start Page

  • 218
  • End Page

  • 223
  • Volume

  • 8
  • Issue

  • 3