7066 Development of hyperplastic antral polyps following treatment of watermelon stomach (wms) with argon plasma coagulator (apc)

• Published in: Gastrointestinal endoscopy Vol. 51; no. 4; p. AB258
• Main Authors: Ter, Roland, G, Haber, Sandha, G., Ponnudurai, R., Ormonde, D., Marcon, N., Kortan, P., Kandel, G.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.04.2000
• ISSN: 0016-5107; 1097-6779
• DOI: 10.1016/S0016-5107(00)14737-6

Introduction: WMS is an unusual cause of gastrointestinal bleeding and iron deficiency anemia. Its etiology is unknown. The main treatment is endoscopic treatment using various modalities including bipolar electrocoagulation, Nd:YAG laser, heater probe or more recently APC. APC is a noncontact thermal modality which is highly effective for the treatment of WMS with minimal complications. Aim:We report 2 cases of development of antral polyps arising at sites of previously treated WMS with APC. Results: 2 patients (1 M, 1 F, 63 and 79 years) were treated for WMS with APC. Each had iron deficiency anemia and had required blood transfusions. Both had been on proton pump inhibitors prior to treatment. Neither had antral polyps before treatment. The male patient had 3 sessions of APC treatment. Six 2-6 mm polyps along the line of erythema were found on subsequent treatment sessions 6 months later. The largest polyp was snared with pathology showing a hyperplastic polyp. There was chronic gastritis with no Helicobacter pylori (HP) on biopsy of antral mucosa. The female patient had 6 sessions of APC treatment. Multiple 2-3 mm antral polyps were discovered along the site of previous APC treatment during the fourth treatment session 3 years later. Biopsy was significant for hyperplastic polyp. These polyps persisted on follow-up. Biopsy of the antral mucosa showed chronic gastritis with no HP.Conclusion: This is the first report of the development of hyperplastic polyps along the sites of previously treated WMS with APC. The long-term consequences of these polyps are unknown.