Chonnam Med J CMJ Chonnam Medical Journal 0377-9564 Chonnam National University Medical School 10.4068/cmj.2009.45.2.132 Case Report Endoscopic Hemoclipping Therapy for Gastric Angiodysplasia in a Child Kim Joon Sung Lee Kyung Yeon Department of Pediatrics, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. Corresponding author (pedkjs@uuh.ulsan.kr) 08 2009 12 08 2009 45 2 132 135 22 07 2009 Copyright © 2009 Chonnam National University Medical School 2009

Gastric angiodysplasia is a very rare cause of upper gastrointestinal bleeding in children and adolescents and is considered to be a vascular abnormality with a developmental cause. Gastric angiodysplasia can be managed with various endoscopic methods, including argon plasma coagulation, electrocoagulation, heater probe, sclerotherapy, band ligation, and hemoclipping therapy. We describe a case of gastric angiodysplasia in a 12-year-old boy with hematemesis and melena. Gastroduodenoscopy showed a typical lesion of angiodysplasia with oozing on the posterior wall of the gastric body. We successfully performed endoscopic hemoclipping therapy to heal the bleeding lesion, and no recurrence of bleeding was observed on follow-up. Gastric angiodysplasia should be included in the differential diagnosis of upper gastrointestinal bleeding in children.

 Angiodysplasia Stomach Gastrointestinal hemorrhage Hemoclipping Foutch PG Angiodysplasia of the gastrointestinal tract Am J Gastroenterol 1993 88 807 818 Bown SG Swain CP Storey OW Collins C Matthewson K Salmon PR Endoscopic laser treatment of vascular anomalies of the upper gastrointestinal tract Gut 1985 26 1338 1348 Cello JP Grendell JH Endoscopic laser treatment for gastrointestinal vascular ectasias Ann Intern Med 1986 104 352 354 Sebastian S O'Morain CA Buckley MJ Review article: current therapeutic options for gastric antral vascular ectasia Aliment Pharmacol Ther 2003 18 157 165 Scully RE Galdabini JJ McNeely BU Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 33-1975 N Engl J Med 1975 293 394 399 Quintero E Pique JM Bombi JA Ros E Bordas JM Rives A Upper gastrointestinal bleeding caused by gastroduodenal vascular malformations Dig Dis Sci 1986 31 897 905 Harloff M Weber J Riemann JF Angiodysplasias in the digestive tract and their clinical significance Med Klin 1987 82 814 817 Helmrich GA Stallworth JR Brown JJ Angiodysplasia: characterization, diagnosis, and advances in treatment South Med J 1990 83 1450 1453 Moore JD Thompson NW Appleman HD Foley D Arteriovenous malformation of the gastrointestinal tract Arch Surg 1976 111 381 389 Gostout CJ Bowyer BA Ahlquist DA Viggiano TR Balm RK Mucosal vascular malformations of the gastrointestinal tract: clinical observations and results of endoscopic neodymium: yttrium-aluminum-garnet laser therapy Mayo Clin Proc 1988 63 993 1003

Endoscopic finding of gastric angiodysplasia shows telangiectatic cherry red spots and fern-like lesion with oozing on the posterior wall of the gastric body.

Endoscopic view of gastric angiodysplasia after the application of hemoclips.