Digestive Diseases and Sciences

, Volume 39, Issue 12, pp 2558–2560 | Cite as

Extragastric Dieulafoy's disease as unusual source of intestinal bleeding

Esophageal visible vessel
  • Daniel Jaspersen
  • Thomas Körner
  • Wolfgang Schorr
  • Martin Brennenstuhl
  • Carl-Heinz Hammar
Esophageal, Gastric, And Duodenal Disorders

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.

Key words

Dieulafoy's disease intestinal bleeding 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Bozkurt TP, Lederer CP, Lux G: Esophageal visible vessel as a cause of massive upper gastrointestinal hemorrhage. Endoscopy 23:16–18, 1991PubMedGoogle Scholar
  2. 2.
    Veldhuyzen van Zanten SJO, Bartelsman JFWM: Recurrent massive haematemesis from Dieulafoy vascular malformations—a review of 101 cases. Gut 27:213–222, 1989Google Scholar
  3. 3.
    Rustgi AK, Compton CC: A 76 year old man with recurrent gastrointestinal bleeding. N Engl J Med 325:1086–1096, 1991PubMedGoogle Scholar
  4. 4.
    Gallard T: Aneurysmes miliaires de l'estomac donnant lieu à des hématémèses montelles. Bull Soc Med Paris 1:84–91, 1884Google Scholar
  5. 5.
    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, 1889Google Scholar
  6. 6.
    Juler GL, Labitzke HG, Lamb R: The pathogenesis of Dieulafoy's gastric erosion. Am J Gastroenterol 79:195–200, 1984PubMedGoogle Scholar
  7. 7.
    Jaspersen D: Dieulafoy's disease controlled by Doppler ultrasound endoscopic treatment. Gut 34:857–858, 1993PubMedGoogle Scholar
  8. 8.
    Jaspersen D, Gaster CB, Koerner T, Hammar CH: Doppler controlled injection treatment of Dieulafoy's disease. J Gastroenterol Hepatol 8:267–269, 1993PubMedGoogle Scholar
  9. 9.
    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, 1993Google Scholar
  10. 10.
    Pointner R, Schwab G, Konigsrainer P: Endoscopic treatment of Dieulafoy's disease. Gastroenterology 94:563–566, 1988PubMedGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1994

Authors and Affiliations

  • Daniel Jaspersen
    • 1
  • Thomas Körner
    • 1
  • Wolfgang Schorr
    • 1
  • Martin Brennenstuhl
    • 1
  • Carl-Heinz Hammar
    • 1
  1. 1.Department of GastroenterologyAcademie Medical HospitalFuldaGermany

Personalised recommendations