- 期刊
以內視鏡診為Dieulafoy潰瘍三例報告
Dieulafoy's Ulcer (Exulceratio Simplex)-Endoscopic Diagnosis of Three Cases
摘要
Dieulafoy潰瘍引起上消化道出血的病例雖是屬於較為罕見者，但仍不可不加以注意。本院在最近兩年間即曾遇到3例Dieulafoy潰瘍的病人，此3例皆為男性，年齡各為20、60及65歲。突發大量吐血而無潰瘍之既往歷，內視鏡檢查發現在胃貴門或胃上體部有活動性之動脈性出血，其中1例施行緊急手術縫合止血，1例施行YAG雷射內視鏡術止血，另1例則施行內視鏡局部注射純酒精，3例皆成功地止血。在上消化道大量出血的病例當中，實行緊急內視鏡檢查時，如遇有動脈性出血之病例，必須考慮有Dieulafoy潰瘍之可能性，而在考慮手術止血之前，內視鏡局部注射純酒精或高張性鹽水腎上腺素液止血法頗值得利用。
並列摘要
Three cases of Dieulafoy's ulcer which gastric bleeding was successfully controlled by means of local injection of pure ethanol in one case, YAG laser photocoagulation in one case and operative suture ligation after gastrostomy in another case. These 3 patients are all male, and 20, 60 and 65 years old respectively. They suffered from sudden onset of hematemesis without apparent past history of peptic ulcer, and urgent panendoscopy revealed active arterial bleeding from small ulcer lesion just close to EG junction of stomach. Local injection of hemostatic agents via endoscope is effective and cheap, easy one method for attempt of obtaining hemostasis in cases of Dieulafoy's ulcer and should be tried prior to surgical intervention. It is important to know this entity and performed urgent endoscopy for cases with unexplained gastrointestinal bleeding, especially with hematemesis.