Abstract

ZAMORA-SOLER, José Ángel  and  MATURANA-IBANEZ, Vanesa. Surgical treatment of upper gastrointestinal bleeding due to Dieulafoy disease. rev. colomb. cir. [online]. 2020, vol.35, n.1, pp.113-118. ISSN 2011-7582.  https://doi.org/10.30944/20117582.595.

Dieulafoy’s disease constitutes less than 2% of the causes of upper gastrointestinal bleeding. It corresponds to the presence of a tortuous arterial blood vessel which protrudes through a localized mucosal defect, usually proximal in the stomach. It presents as a massive hematemesis, sometimes recurrent, with hemodynamic instability.

Endoscopy is the diagnostic and therapeutic method of choice. If this fails, it is indicated to perform a selective angiography to identify the bleeding point and embolize it. In some cases, none of these two techniques manages to stop the bleeding, in which case urgent surgery is indicated. Limited gastric resections (wedge or tubular gastrectomies) should be performed to the bleeding area, thus avoiding large gastrectomies that involve anastomosis due to the high leak risk they have in hemodynamically unstable patients.

We present the case of a patient with upper gastrointestinal bleeding secondary to Dieulafoy’s disease, who required urgent surgical intervention due to the impossibility of resolving the bleeding endoscopically. The diagnosis and treatment of Dieulafoy’s disease as a cause of upper gastrointestinal bleeding in adults are described and a review of the scientific literature is presented.

Keywords : upper gastrointestinal tract; gastrointestinal hemorrhage; duodenal ulcer; endoscopy, gastrointestinal; diagnosis, differential; digestive system surgical procedures.

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