dieulafoy
A hypothetical case
A 32 year old gentleman with no past history of alcoholism or smoking presented at the ED for haematemesis and malaena for 2 days (not a local case). He denied severe retching or vomiting prior to the onset of his complaint. This obviosu case of BGIT was complicated by cardiovascular embarrassment with low BP, sinus tachycardia and AMS.
PCTs and fluids were given.
The GI team was called in. The working diagnosis was that of peptic ulcer disease involving an artery resulting in BGIT.
An OGD was done asap and a gastric artery aneurysm (aka Dieulafoy lesion aka Exculceratio Simplex) was found in the upper half of the stomach along the lesser curvature (classic site).
Endoscopic sclerotherapy was performed and the patient was discharged well.
Notes:
Dieulafoy lesions are relatively rare (duh. any weird names are usually rare)
Extragastric invovlement is possible:
- Duodenum is next commonest
- Colon
- Esophagus
- Jejunum
A 32 year old gentleman with no past history of alcoholism or smoking presented at the ED for haematemesis and malaena for 2 days (not a local case). He denied severe retching or vomiting prior to the onset of his complaint. This obviosu case of BGIT was complicated by cardiovascular embarrassment with low BP, sinus tachycardia and AMS.
PCTs and fluids were given.
The GI team was called in. The working diagnosis was that of peptic ulcer disease involving an artery resulting in BGIT.
An OGD was done asap and a gastric artery aneurysm (aka Dieulafoy lesion aka Exculceratio Simplex) was found in the upper half of the stomach along the lesser curvature (classic site).
Endoscopic sclerotherapy was performed and the patient was discharged well.
Notes:
Dieulafoy lesions are relatively rare (duh. any weird names are usually rare)
Extragastric invovlement is possible:
- Duodenum is next commonest
- Colon
- Esophagus
- Jejunum
posted by scientia at
5:56 AM
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