Al-Busaidi Alsalt, Alomairi Jaifar, Alabri Omer, Alwheibi Eissa, Almaghadari Alazhar, Kadom Mhmod R, O'Connell P Ronan
School of Medicine, Royal College of Surgeons in Ireland, Dublin, IRL.
Surgery, University College Dublin, Dublin, IRL.
EXCLI J. 2023 Aug 17;22:862-866. doi: 10.17179/excli2023-6407. eCollection 2023.
Dieulafoy's lesion is a life-threatening and rare vascular malformation of the submucosal vessel that protrudes to the mucosa of the gastrointestinal tract. The vessel is abnormally dilated, and if it ruptures, it can cause severe acute gastrointestinal bleeding. We report an upper GI bleeding case due to Dieulafoy's lesion in the gastric fundus of the stomach in a 76-year-old female. The patient presented with hematemesis and melena associated with anemia. An esophagogastroduodenoscopy (OGD) was performed which showed profuse pulsatile bleeding at the gastric fundus. Following that, gastrotomy confirmed the diagnosis of Dieulafoy's lesion. Endoscopy is the main diagnostic and therapeutic tool for Dieulafoy's lesion. Endoscopic treatment includes injective, ablative and mechanical therapies. The majority of cases are treated endoscopically, while in some cases, surgical intervention is deemed to be necessary as it is currently the only definitive treatment of Dieulafoy's lesion.
Dieulafoy病是一种危及生命的罕见的黏膜下血管畸形,突出于胃肠道黏膜。该血管异常扩张,一旦破裂,可导致严重的急性胃肠道出血。我们报告一例76岁女性因胃底Dieulafoy病导致上消化道出血的病例。患者出现呕血、黑便并伴有贫血。进行了食管胃十二指肠镜检查(OGD),显示胃底有大量搏动性出血。随后,剖腹探查术确诊为Dieulafoy病。内镜检查是Dieulafoy病的主要诊断和治疗工具。内镜治疗包括注射、消融和机械治疗。大多数病例采用内镜治疗,而在某些情况下,手术干预被认为是必要的,因为目前它是Dieulafoy病唯一的确定性治疗方法。