Watermelon stomach in systemic sclerosis

Systemic sclerosis (SSc) is a connective tissue disorder characterized by microvascular involvement, which very frequently targets the digestive tract. Gastrointestinal involvement is noted in up to 90% of cases, the segment most frequently involved being the esophagus although the entire digestive tract may be affected. Gastroesophageal reflux is the most common symptom but other unusual complications may also occur. Gastric antral vascular ectasia (GAVE) or watermelon stomach is one such rare lesion; it relates to a disturbed capillary bed, which appears dilated, sometimes with thrombi under the mucosa. This lesion is one expression of generalized SSc microvasculopathy. Its prevalence is not precisely known but appears to be weak; however, it remains a cause of anemia clinicians should be aware of. Indeed, specific local treatment must be delivered and is usually efficient despite frequent recurrent events. (C) 2010 Elsevier Masson SAS. All rights reserved.