Abdoh Qusay, Samara Enas, Zayed Alaa, Khader Mohammed, Maqboul Iyad, Rashed Mohammed A M
Department of Internal Medicine, GI and Endoscopy Unit, An-Najah National University Hospital, Asira Street, Nablus, Palestine.
Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Al-Junaid Street, Nablus, Palestine.
J Surg Case Rep. 2024 Dec 5;2024(12):rjae750. doi: 10.1093/jscr/rjae750. eCollection 2024 Dec.
Dieulafoy lesions are a rare cause of gastrointestinal bleeding, characterized by an enlarged submucosal blood vessel that bleeds without visible abnormalities. The diagnosis is typically made via endoscopy, and treatment usually involves endoscopic therapy. This case involves a 46-year-old female who presented with upper gastrointestinal bleeding due to a Dieulafoy's lesion, treated with band ligation and later embolization after the lesion was found to originate from the left phrenic artery. The patient developed rare complications, including splenic infarction and pleural effusion, which required additional management. Upon initial investigations, the patients had an accidental finding on computed tomography of asymptomatic celiac artery compression that was advised to take into consideration for the possibility of developing median arcuate ligament syndrome and was treated conservatively. The case highlights the diagnostic and therapeutic challenges of Dieulafoy's lesion and underscores the need for individualized treatment and further research.
Dieulafoy病变是胃肠道出血的罕见原因，其特征是黏膜下血管扩张，出血时无明显异常。诊断通常通过内镜检查进行，治疗通常包括内镜治疗。本病例涉及一名46岁女性，因Dieulafoy病变出现上消化道出血，先接受了套扎治疗，在发现病变起源于左膈动脉后又进行了栓塞治疗。患者出现了罕见的并发症，包括脾梗死和胸腔积液，需要进一步处理。在初步检查时，患者在计算机断层扫描中意外发现无症状的腹腔动脉压迫，建议考虑发展为正中弓状韧带综合征的可能性，并进行了保守治疗。该病例凸显了Dieulafoy病变的诊断和治疗挑战，并强调了个体化治疗和进一步研究的必要性。
