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[The Dieulafoy's ulcer (author's transl)]
Leber, Magen, Darm
|December 1, 1977
Summary
Dieulafoy's ulcer, a condition often linked to alcohol and tobacco use, requires prompt endoscopic diagnosis during bleeding episodes. Surgical intervention, specifically vessel ligation, offers excellent outcomes, making extensive resections unnecessary.
Area of Science:
- Gastroenterology
- Surgical Oncology
Background:
- Dieulafoy's ulcer is a rare but potentially life-threatening cause of gastrointestinal bleeding.
- High consumption of alcohol and tobacco was noted in all studied patients.
Observation:
- Five patients with Dieulafoy's ulcer underwent successful surgery at Innsbruck University Surgical Clinic between 1971-1976.
- Gastroscopy is the preferred diagnostic tool, especially during active hemorrhage, to identify subtle mucosal changes.
- Endoscopic identification and suturing of the bleeding vessel is the primary therapeutic strategy.
Findings:
- Surgical procedures like resections, particularly blind resections, are not recommended.
- In cases where the bleeding vessel isn't found endoscopically, a large gastrotomy with careful inspection is advised.
- All patients experienced excellent long-term outcomes (up to 64 months) without recurrence.
Implications:
- Timely and accurate diagnosis via endoscopy is crucial for effective management.
- Surgical ligation of the bleeding vessel is a highly effective treatment for Dieulafoy's ulcer.
- The prognosis for Dieulafoy's ulcer is favorable with appropriate diagnostic and surgical approaches.