Gast ric antral vascular ectasia (GAVE) is a rare cause of upper gastrointestinal (GI) bleeding, accounting for 4% of nonvariceal upper GI bleeding and associated with occult bleeding that manifests as iron deficiency anemia. 1 In recent years, it has emerged as a distinctive, well-defined entity within the spectrum of acquired vasculopathies of the stomach.We report two cases of GAVE presenting with two different endoscopy findings. We discuss the etiology, endoscopic features, histology, pathogenesis, and management options of this rare entity, and present a review of the pertinent literature. Case 1A man, age 57 years, presented with a one-week history of hematemesis. He described three episodes of coffee ground emesis, about a half-cupful on each occasion. The most recent episode occurred on the day of admission. His past medical history was significant for alcoholic cirrhosis with portal hypertension. He had an episode of hematochezia in the past that was diagnosed as a diverticular bleed on colonoscopy. His social history was significant for alcohol abuse, but he had quit drinking about 10 years prior.His vital signs showed a temperature of 98.9 o F, pulse 102 beats/minute, respiratory rate 16 breaths/minute, and blood pressure 120/79 mm Hg. Physical examination revealed a pale, jaundiced, malnourished male with ascites, pedal edema, and bilateral basal crackles. Initial laboratory studies were significant for hemoglobin of 8.8 gm/dL (reference range 12.9-17.3 g/dL). Serum liver tests Gastric antral vascular ectasia is the source of up to 4% of nonvariceal upper gastrointestinal bleeding. It can present with occult bleeding requiring transfusions or with acute gastrointestinal bleeding. It is associated with significant morbidity and mortality and has been associated with such underlying chronic diseases as scleroderma, diabetes mellitus, and hypertension. Approximately 30% of cases are associated with cirrhosis. We report two cases of gastric antral vascular ectasia with two strikingly different endoscopic appearances. We further describe the clinical, endoscopic, histologic, and therapeutic aspects of this entity.

A case of Fusobacterium necrophorum bacteremia and multiple brain abscesses in a 6-year-old child following a Mycoplasma pneumoniae infection is described. Brain abscess due to this microorganism has only been described in three other cases since 1977. The clinical picture was consistent with postanginal septicemia, with septic metastatic complications normally only seen in teenagers and young adults. The patient was successfully treated with a 2-month course of parenteral penicillin G and metronidazole.

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