Dieulafoy's Ulcer Leading to Gastrectomy Following Endoscopic Hemostasis, Report of a Case Atsushi Kano 1 , Kunio Sato 1 , Junichi Sekiguchi 2 , Shigeki Narasaka 2 , Isao Onodera 2 1The First Department of Internal Medicine, Iwate Medical University, School of Medicine 2Iwate Prefectural Yamada Hospital pp.1155-1159
Published Date 1987/10/25
DOI https://doi.org/10.11477/mf.1403112952
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 We experienced a case of Dieulafoy's urcer in which endoscopic hemostasis was performed before gastrectomy. A 65-year-old male with a past history of hypertension and gastric ulcer suffered from a sudden onset of hematemesis. He complained of vertigo and headache on admission. In the first endoscopic examination (Fig. 1), a small blood clot was observed on the posterior wall of the lower gastric body. Endoscopic hemostasis was immediately conducted for the prophylactic purpose using HS-E method. However, massive rebleeding occurred on the 5th hospital day (Fig. 3). Endoscopic hemostasis was successfully done again. Oozing of fresh blood from the lesion was again recognized endoscopically on the 20th hospital day (Fig. 6) and gastrectomy was performed prophylactically on the 22nd hospital day. Angiography was conducted postoperatively.

 Histological examination revealed a large artery running in the submucosa just under the mucosa (Fig. 9a). A ruptured part of the vessel filled with thrombus was covered with fibrosis and regenerative mucosa (Fig. 9b).

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