Abstract
Dieulafoy's disease is a gastric vascular malformation, which typically causes massive hemorrhage. The lesion is most often found in the proximal stomach, but has also been reported in the esophagus and in the small intestine. Three patients with esophageal Dieulafoy's anomaly and recurrent bleeding are reported. For the first time, transendoscopic Doppler ultrasound was used to identify arterial blood flow from the lesions. The ulcerations were treated by injection of adrenaline. Successful therapy resulted in the disappearance of arterial pulsations and no rebleeding occurred. Doppler-controlled endoscopic intervention should be the first line of treatment in the esophageal vessel stump.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bozkurt TP, Lederer CP, Lux G: Esophageal visible vessel as a cause of massive upper gastrointestinal hemorrhage. Endoscopy 23:16–18, 1991
Veldhuyzen van Zanten SJO, Bartelsman JFWM: Recurrent massive haematemesis from Dieulafoy vascular malformations—a review of 101 cases. Gut 27:213–222, 1989
Rustgi AK, Compton CC: A 76 year old man with recurrent gastrointestinal bleeding. N Engl J Med 325:1086–1096, 1991
Gallard T: Aneurysmes miliaires de l'estomac donnant lieu à des hématémèses montelles. Bull Soc Med Paris 1:84–91, 1884
Dieulafoy G: Exulceratio simplex. L'intervention chirurgicale dans les hématémèses foudroyantes consecutives à l'exulcération simplex de l'estomac. Bull Acad Med 39:49–84, 1889
Juler GL, Labitzke HG, Lamb R: The pathogenesis of Dieulafoy's gastric erosion. Am J Gastroenterol 79:195–200, 1984
Jaspersen D: Dieulafoy's disease controlled by Doppler ultrasound endoscopic treatment. Gut 34:857–858, 1993
Jaspersen D, Gaster CB, Koerner T, Hammar CH: Doppler controlled injection treatment of Dieulafoy's disease. J Gastroenterol Hepatol 8:267–269, 1993
Jaspersen D, Koerner T, Schorr W, Wzatek J, Hammar CH, Klingmann R: Diagnosis and treatment control of gastroduodenal ulcer haemorrhage with an endoscopic Doppler device. Eur J Gastroenterol Hepatol 5:471–474, 1993
Pointner R, Schwab G, Konigsrainer P: Endoscopic treatment of Dieulafoy's disease. Gastroenterology 94:563–566, 1988
Author information
Authors and Affiliations
Additional information
This article is dedicated to Prof. Rudolf Arnold, M.D., University Hospital of Marburg, FRG.
Rights and permissions
About this article
Cite this article
Jaspersen, D., Körner, T., Schorr, W. et al. Extragastric Dieulafoy's disease as unusual source of intestinal bleeding. Digest Dis Sci 39, 2558–2560 (1994). https://doi.org/10.1007/BF02087690
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02087690