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Massive gastric bleeding from exulceratio simplex (Dieulafoy).

A Bakka, A R Rosseland

    Acta Chirurgica Scandinavica
    |April 1, 1986
    PubMed
    Summary
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    Dieulafoy lesions can cause massive upper gastrointestinal bleeding. This study highlights the importance of recognizing and treating this rare but life-threatening condition, with successful outcomes achieved through endoscopy or surgery.

    Area of Science:

    • Gastroenterology
    • Surgical Gastroenterology

    Background:

    • Massive upper gastrointestinal hemorrhage is a serious condition.
    • Ulcus simplex Dieulafoy (Dieulafoy lesion) is a rare cause of such bleeding.
    • Early recognition and treatment are crucial for patient survival.

    Purpose of the Study:

    • To report on the diagnostic and therapeutic challenges of Dieulafoy lesions.
    • To emphasize the importance of considering Dieulafoy lesions in cases of massive gastrointestinal bleeding.
    • To present treatment outcomes for patients with Dieulafoy lesions.

    Main Methods:

    • Retrospective analysis of 144 patients operated on for benign gastric ulcers between 1975-1980.
    • Identification of Dieulafoy lesions in patients presenting with emergency massive gastric bleeding.

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  • Diagnostic methods included fiberoptic endoscopy and gastrotomy.
  • Treatment modalities included gastroscopic coagulation and surgical intervention.

    • Main Results:

    • Six out of 29 emergency admissions for massive gastric bleeding were diagnosed with Dieulafoy lesions.
    • Fiberoptic endoscopy successfully identified the bleeding source in five cases.
    • All six patients with Dieulafoy lesions were successfully treated.
    • One patient received gastroscopic coagulation, while five underwent surgical treatment.
    • No recurrence of bleeding was observed in any of the treated patients.

    Conclusions:

    • Dieulafoy lesions are a rare but potentially life-threatening cause of massive upper gastrointestinal hemorrhage.
    • Accurate diagnosis, often requiring endoscopy, is essential.
    • Both endoscopic and surgical treatments can be highly effective.
    • Increased awareness and recognition are necessary for timely management of this condition.