Jaiswal Palashkumar, Joseph-Talreja Mairin, Teotico John Anthony, Grossman Evan
Division of Gastroenterology and Hepatology, Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY.
Department of Internal Medicine, SUNY Downstate Medical Center, Brooklyn, NY.
ACG Case Rep J. 2020 Jun 22;7(6):e00400. doi: 10.14309/crj.0000000000000400. eCollection 2020 Jun.
Dieulafoy's lesion is a histologically normal arteriole that has failed to progressively narrow as it navigates through the submucosa. It is a rare cause of massive gastrointestinal bleeding, occurring most often in the stomach, with only 1% of lesions occurring in the jejunum. We present the case of a 21-year-old man who presented with massive hematochezia ultimately attributed to a distal jejunal Dieulafoy's lesion, identified via an intraoperative surgically assisted deep enteroscopy. This case is unique not only regarding the unusual location of the lesion but also regarding the multidisciplinary approach necessitated for the management of this catastrophic hemorrhage that avoided surgical resection.
Dieulafoy病是一种组织学上正常的小动脉，在穿过黏膜下层时未能逐渐变窄。它是引起大量胃肠道出血的罕见原因，最常发生于胃，仅1%的病变发生在空肠。我们报告一例21岁男性患者，其表现为大量便血，最终归因于空肠远端的Dieulafoy病，通过术中手术辅助深部小肠镜检查得以确诊。该病例不仅病变位置不寻常，而且在处理这种灾难性出血时需要多学科方法，避免了手术切除，因而具有独特性。
