Exulceratio simplex（Dieulafoy潰瘍）自験例の検討

Exulceratio Simplex Dieulafoy, Report of Cases

要旨　1975年から1986年の間に，われわれの病院でDieulafoy潰瘍の臨床診断で取り扱った症例は18例である．このうち，3例は内視鏡止血法により治癒したので，外科的治療を行った15例について血管構築を含む組織学的検索を試みた．その結果，Dieulafoy潰瘍の典型的なカテゴリーに属する症例は6例で33.3％であった．Dieulafoy潰瘍の確定診断のためには粘膜下層における異常血管を明らかにする必要がある．しかし，今後は内視鏡的止血法により治癒する症例も増加すると思われるので，臨床診断に当たっては十分に注意する必要があろう．

　We have clinically experienced 18 cases of the so-called Dieulafoy's ulcer in our hospital from 1975 to 1986. Three cases were treated endoscopically and the remaining 15 cases surgically. Submucosal blood vessel structure was histologically examined in such operated cases.

　The result showed that 6 cases (33.3%) fulfilled the original Dieulafoy's criteria. It should be noted here that the presence of abnormal artery in the submucosa, i.e., pathological specimen, was required in making a diagnosis of Dieulafoy's ulcer.

　Considering the recent trend of increasing use of endoscopic technique in treating Dieulafoy's ulcer, we have to entertain the possibility of Dieulafoy's ulcer in more cases than currently diagnosed.