Mahmoud Aryan*, Ravi Jariwala, Basem Alkurdi, Shajan Peter, Mohamed Shoreibah
Aryan et al. J Clin Transl Res 2022; 8(3):8
Published online: May 25, 2022
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 amongst patients undergoing esophagogastroduodenoscopy (EGD)
Methods: We performed a retrospective review of 941 EGDs between 2017-2019. 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 amongst 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 (κ=0.35)
Conclusions: Our findings indicate GAVE was misclasssified 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.
DOI: http://dx.doi.org/10.18053/jctres.08.202203.008
Author affiliation
1. Tinsley Harrison Internal Medicine Residency, Department of Medicine, University of Alabama at
Birmingham, 1720 2nd Avenue South, BDB 327, Birmingham, AL 35294, United States
2. Department of Gastroenterology and Hepatology, Ochsner Medical Center, 1514 Jefferson Hwy.
New Orleans, LA 70121, United States
3.Division of Gastroenterology and Hepatology, Department of Medicine, University of Alabama at Birmingham, 1808 7th Avenue South, BDB 391, Birmingham, AL 35294, United States
*Corresponding author
Mahmoud Aryan
Tinsley Harrison Internal Medicine Residency, Department of Medicine, University of Alabama at Birmingham, 1720 2nd Avenue South, BDB 327, Birmingham, AL 35294, United States
Tel: 205-934-2490
Email: mahmoudaaryan@gmail.com
Handling editor:
Michal Heger
Department of Pharmaceutics, Utrecht University, the Netherlands
Department of Pharmaceutics, Jiaxing University Medical College, Zhejiang, China
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