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Diagnostic Aspects of Dieulafoy's Ulcer Mitsuyo Hashimoto 1 , Sotaro Fukuchi 1 , Kazuo Hayakawa 1 , Yukiya Yoshida 1 , Masamitsu Unakami 2 1Department of Gastroenterology, Toranomon Hospital 2Department of Pathology, Toranomon Hospital pp.1135-1141
Published Date 1987/10/25
DOI https://doi.org/10.11477/mf.1403112949
  • Abstract
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 Dieulafoy's ulcer, though rare as a cause of upper gastrointestinal bleeding, requires prompt diagnosis because of its rapid clinical course. Endoscopy plays an important role as a diagnostic method and more so as endoscopic hemostasis has recently made conservative hemostasis possible. Dieulafoy's ulcer occurs most frequently on the anterior or posterior wall near the lesser curvature of the upper gastric body.

 Endoscopically it is characterized by a slight elevation due to large artery in a small, shallow Ul-Ⅱ accompanied by neither a converging fold, surrounding elevation nor apparent regenerative reaction. Although the essential feature of Dieulafoy's ulcer is generally considered to be an abnormally tortuous and large artery in the submucosa, diagnostic criteria regarding the size of the artery or shallow mucosal defect are not yet firmly established. There is a possibility that repetitive spontaneous hemostasis for long period of time or endoscopic hemostasis causes pathological changes in the ulcer and artery, quite different from the acute phase findings.


Copyright © 1987, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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