Exulceratio simplex dieulafoy

During a three year period, 18 patients with the Exulceratio Simplex Dieulafoy lesion of the stomach were treated (nine males and nine females). Because of intermittent bleeding episodes, lack of chronic ulceration of the gastric mucosa and the location of the lesion (most common in the upper part of the stomach), the lesion is easily overlooked at endoscopy and even at laparotomy with gastrotomy. Our treatment includes repeated endoscopies, attempted hemostasis with a combination of injection sclerotherapy and electrocoagulation and, if this is not successful, emergency surgical treatment with wedge resection using a technique with the TA 90 (U. S. Surgical Corp.) linear stapler. The diagnostic and therapeutic problems are discussed on the basis of patient profiles.