Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic iron deficiency anemia of obscure origin. Reports history of melena or hematochezia. Denies epigastric pain, nausea, or vomiting. No history of NSAID abuse or alcohol misuse. Symptoms consistent with diffuse GAVE (Watermelon stomach), requiring endoscopic evaluation and potential intervention.
Clinical Examination Findings
Physical examination reveals conjunctival pallor and tachycardia consistent with chronic anemia. Abdominal exam is soft, non-tender, without palpable masses or organomegaly. No signs of chronic liver disease or portal hypertension (e.g., spider angiomata, caput medusae, ascites). Stool guaiac test is positive.
Treatment Protocol
Endoscopic therapy is the gold standard. Recommended treatment: Argon Plasma Coagulation (APC) for diffuse vascular ectasia. Consider secondary iron supplementation and monitoring of hemoglobin levels. If refractory, evaluate for surgical antrectomy.