Background: Watermelon stomach (GAVE syndrome) is an unusual vascular lesion of the antrum. This entity represents a rare cause of upper gastrointestinal bleeding and its etiology is unknown.
Objective: To describe two cases of upper gastrointestinal hemorrhage secondary to watermelon stomach associated with renal disease recently seen in our center.
Setting: Tertiary referral center
Case 1: An 86 year-old man consulted for melena for the past three weeks. His medical history included left nephrectomy (renal cell carcinoma), nephrolithiasis, chronic renal insufficiency and gastritis.Other than melena, the patient didn't have any other gastrointestinal symptoms. His hemoglobin level at arrival was 57 g/l. It was at 111 g/l six months before. An upper GI endoscopy done one year before was normal. The present upper endoscopy revealed vascular lesions confined to the antrum suggestive of watermelon stomach. We cauterized the lesions with heater probe with good results.
Case 2: A 49 year-old woman with a history of diabetes mellitus resulting in nephropathy and retinopathy came to the emergency room for melena.Hemoglobin was at 67 g/l. Her past medical history included hypothyroidism, arterial hypertension and obesity.The initial upper GI endoscopy showed a watermelon stomach with localized oozing. Multiple heater probe sessions were performed to treat these vascular lesions.

Conclusion: Watermelon stomach (GAVE syndrome) is associated with chronic renal disease in these two cases. Review of the literature will be discussed.

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