An 80-year-old man with chronic renal failure and a splenorenal shunt was admitted because of progressive anemia. Gastrointestinal endoscopy revealed bleeding from a gastric antral vascular ectasia (GAVE). Despite treatment with argon plasma coagulation and blood transfusions on multiple occasions, anemia caused by GAVE bleeding recurred frequently. The GAVE improved after splenorenal shunt embolization, and the patient did not require further blood transfusions for anemia. In this case, we inferred that some humoral factor (e.g., gastrin) in the portal blood caused the GAVE.
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