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诊断难题:一例十二指肠Dieulafoy病变与胃溃疡并存的病例报告

A diagnostic dilemma: a case report of concomitant duodenal Dieulafoy lesion and gastric ulcer.

作者信息

Wallace Lauren, Gallagher Peter J

机构信息

Department of General Surgery, The Royal Melbourne Hospital, 300 Grattan Street, Parkville, Victoria, 3052, Australia.

Department of Surgery, Grampians Health Wimmera Base Hospital, 83 Baillie Street, Horsham, Victoria, 3400, Australia.

出版信息

J Surg Case Rep. 2024 Mar 8;2024(3):rjae122. doi: 10.1093/jscr/rjae122. eCollection 2024 Mar.

Abstract

Dieulafoy lesions (DL) are an uncommon cause of gastrointestinal bleeding which is often difficult to diagnose due to the rarity of the condition and varying clinical presentations. This case describes an unusual presentation of upper gastrointestinal bleeding in an 85-year-old female with findings on two separate gastroscopies of both a gastric ulcer and duodenal DL. The pathophysiology of DL remains poorly understood and despite shared risk factors, these two pathologies are rarely reported concurrently. The presence of a concomitant gastric ulcer further complicated the diagnosis and treatment of the duodenal DL in this case. This highlights the importance of clinician awareness of this pathology and its presentation and the need for early repeat endoscopy.

摘要

Dieulafoy病变(DL)是胃肠道出血的一种罕见病因,由于该病罕见且临床表现各异,常常难以诊断。本病例描述了一名85岁女性上消化道出血的不寻常表现,在两次独立的胃镜检查中发现了胃溃疡和十二指肠DL。DL的病理生理学仍知之甚少,尽管存在共同的危险因素,但这两种病变很少同时报道。在本病例中,同时存在的胃溃疡使十二指肠DL的诊断和治疗更加复杂。这突出了临床医生对这种病变及其表现的认识的重要性,以及早期重复内镜检查的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe77/10924729/576926a26e46/rjae122f1.jpg

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