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

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Authors: Šramková M.; Kroupa R.; Dastych M.; Konečný Š.; Kunovsky L.; Dolina J.
Authors‘ workplace: Department of Gastroenterology and Internal Medicine, Universtity Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic
Published in: Gastroent Hepatol 2021; 75(3): 221-228
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doi: https://doi.org/10.48095/ccgh2021221

Overview

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:

cévní ektázie žaludečního antra – argon-plazma koagulace – endoskopická ligace – thalidomid – krvácení z trávicího traktu

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