Exulceratio Simplex (Dieulafoy), Report of a Case Atsushi Toyonaga 1 , Takashi Ueda 1 , Kiyoshi Rikitake 1 , Ryuji Nakano 2 , Yasuki Yasumoto 3 1The Second Department of Internal Medicine, Kurume University, School of Medicine 2The Second Department of Pathology, Kurume University, School of Medicine 3Yasumoto Hospital pp.1169-1172
Published Date 1987/10/25
DOI https://doi.org/10.11477/mf.1403112955
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 A 75-year-old male was admitted to the hospital because of sudden onset of hematemesis causing preshock status.

 Emergency endoscopy revealed an exposed blood vessel resulting in oozing of blood in the upper corpus of the stomach (Fig. 1a). Endoscopic hemostasis was successfully made by local injection of hypersaline epinephrine solution at that time (Fig. 1b, c).

 On the 5th day after the treatment, the patient again developed bleeding (Fig. 2a) and fell into shock status despite of immediately tried endoscopic hemostasis (Fig. 2b, c) this time. Subsequently surgical treatment was performed on the same day. Histopathological study of the resected specimen showed a rupture of abnormally large artery in the submucosal layer, which formed the basis of our diagnosing Exulceratio simplex (Dieulafoy) (Figs. 3-6).

 To consider a possibility of Exulceratio simplex is important in the treatment of massive gastric bleeding.

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


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