Inayat Faisal, Ullah Waqas, Hussain Qulsoom, Hurairah Abu
New York-Presbyterian Hospital, Weill Cornell Medical College, New York City, New York, USA.
University of Arizona, Tucson, Arizona, USA.
BMJ Case Rep. 2017 Jan 6;2017:bcr2016218100. doi: 10.1136/bcr-2016-218100.
Dieulafoy's lesion is a vascular abnormality consisting of a tortuous, dilated aberrant submucosal vessel that erodes the overlying mucosal layer without ulceration. The oesophagus is a very rare location for the lesion. Herein, we report a case series of 3 patients who presented with upper gastrointestinal bleeding. Endoscopy was performed, which showed a large calibre-persistent tortuous submucosal artery protruding into the oesophageal lumen. All the patients were successfully managed with endoscopic intervention using epinephrine injection around the lesion followed by hemoclip application. The present paper highlights the remarkably rare occurrence of oesophageal Dieulafoy's lesion and reviews the pathophysiology, epidemiology and management with a focus on diagnostic challenge encountered in such patients.
Dieulafoy病变是一种血管异常,由一条迂曲、扩张的异常黏膜下血管组成,该血管侵蚀上方黏膜层但无溃疡形成。食管是该病变非常罕见的发生部位。在此,我们报告一组3例表现为上消化道出血的病例系列。进行了内镜检查,结果显示一条大口径、持续迂曲的黏膜下动脉突入食管腔。所有患者均通过在内镜下于病变周围注射肾上腺素,随后应用止血夹成功治疗。本文强调了食管Dieulafoy病变极为罕见的发生情况,并回顾了其病理生理学、流行病学及治疗方法,重点关注此类患者所面临的诊断挑战。