Gastric Hyperplastic Polyps after Argon Plasma Coagulation for Gastric Antral Vascular Ectasia in Patients with Liver Cirrhosis: A Case Suggesting the "Gastrin Link Theory"

Intern Med. 2021 Apr 1;60(7):1019-1025. doi: 10.2169/internalmedicine.5837-20. Epub 2020 Oct 28.

Abstract

We herein report a case of gastric hyperplastic polyps after argon plasma coagulation (APC) for gastric antral vascular ectasia (GAVE) in the antrum of a 65-year-old man with liver cirrhosis and hypergastrinemia induced by long-term proton pump inhibitor (PPI) use. Two years after APC therapy, endoscopy demonstrated multiple gastric polyps in the antrum and angle. A gastric polyp biopsy indicated foveolar epithelium hyperplasia, which was diagnosed as gastric hyperplastic polyps. One year after switching to an H2 blocker antagonist, endoscopy revealed that the polyps and GAVE had disappeared, with normal gastrin levels suggesting that PPI-induced hypergastrinemia had caused gastric hyperplastic polyps after APC therapy, and the polyps had disappeared after discontinuing PPIs.

Keywords: argon plasma coagulation; gastric antral vascular ectasia; gastric polyp; hypergastrinemia; proton pump inhibitor.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Argon Plasma Coagulation
  • Gastric Antral Vascular Ectasia* / etiology
  • Gastrins
  • Humans
  • Liver Cirrhosis
  • Male
  • Polyps*
  • Stomach Neoplasms*

Substances

  • Gastrins