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[Dieulafoy's vascular disease]
Insights
Dieulafoy's vascular disease causes upper gastrointestinal bleeding from a prominent submucosal artery. Surgical resection is the most effective treatment for this condition.
Area of Science:
- Gastroenterology
- Vascular Surgery
- Pathology
Context:
- Dieulafoy's vascular disease is a rare but significant cause of upper gastrointestinal hemorrhage.
- The condition involves a focal defect in the gastric submucosal artery.
- Diagnosis and management can be challenging due to the subtle nature of the lesion.
Purpose:
- To report four cases of Dieulafoy's vascular disease.
- To describe the clinical presentation, diagnostic methods, and treatment outcomes.
- To highlight the importance of surgical resection as an effective therapeutic measure.
Summary:
- Four patients with Dieulafoy's vascular disease presented with upper gastrointestinal bleeding.
- The bleeding originated from a large, tortuous submucosal artery eroding the gastric mucosa.
- The lesion was typically located near the gastroesophageal junction, along the lesser curvature.
- Diagnosis was confirmed via endoscopy or during emergency surgery.
- Surgical resection proved to be the most effective treatment in all reported cases.
Impact:
- This case series contributes to understanding the pathophysiology and clinical course of Dieulafoy's vascular disease.
- It underscores the efficacy of surgical intervention for managing severe gastrointestinal bleeding from this cause.
- Findings may guide clinicians in diagnosing and treating similar rare vascular anomalies of the upper gastrointestinal tract.
Abstract:
Four cases are reported of upper gastrointestinal hemorrhage caused by Dieulafoy's vascular disease treated in our service over the last 15 years. In all these patients bleeding was from an unusually long artery with a tortuous trajectory through the gastric submucosa that eroded the mucosa and caused blood loss. In 75% of the cases it was located 6 cm below the gastroesophageal junction, near the small curvature. The diagnosis is usually made by endoscopy or during emergency gastrostomy. The most effective therapeutic measure is surgical resection.