Polit S A
Department of Internal Medicine, Michael Reese Health Plan, Chicago, Illinois.
J Am Geriatr Soc. 1990 Jan;38(1):53-5. doi: 10.1111/j.1532-5415.1990.tb01597.x.
Definitive treatment of the Dieulafoy erosion--once recognized--has generally been surgery. Numerous surgical approaches have been suggested, including: simple oversewing of the lesion, wedge restriction, and gastrectomy with and without vagotomy and pyloroplasty. Attempts at endoscopic electrocoagulation and angiographic embolization have generally been disappointing; however, Pointer et al have recently reported satisfactory control of hemorrhage from Dieulafoy lesions with bipolar electrocoagulation and endoscopic injection sclerotherapy, either independently or in combination. These case reports describe two elderly patients with massive upper gastrointestinal tract bleeding from Dieulafoy's gastric erosion; it is hoped the geriatrician will be alerted to an often unrecognized source of hemorrhage.
一旦确诊，Dieulafoy糜烂的确定性治疗通常是手术。人们提出了许多手术方法，包括：对病变进行单纯缝扎、楔形切除，以及有或无迷走神经切断术和幽门成形术的胃切除术。内镜下电凝和血管造影栓塞术的尝试通常令人失望；然而，波因特等人最近报告称，单独或联合使用双极电凝和内镜注射硬化疗法可有效控制Dieulafoy病变引起的出血。这些病例报告描述了两名因Dieulafoy胃糜烂导致大量上消化道出血的老年患者；希望老年病医生能注意到这一常常未被认识到的出血源。
