Hemostatic powder with argon plasma coagulation in the management of gastric antral vascular ectasia after failure of APC therapy alone.

A 62-year-old woman with a medical history of cirrhosis due to advanced primary biliary cholangitis was referred for recurrent severe anemia. Upper GI endoscopy revealed a gastric antral vascular ectasia (GAVE). The hemoglobin levels were measured between 3 and 6 mg/dl for 10 years, and she received blood transfusion 2-3 times a year and continued endoscopic treatment. In particular, for 2 years from 2018, the decrease in hemoglobin level continued to be more severe, and endoscopic hemostasis using argon plasma coagulation (APC) was performed 11 times in total, but there was no significant clinical improvement.