抄録
Dieulafoy's ulcer, a special category, is one of the serious gastric lesions with a high mortality rate even in individuals without bleeding tendency. We present two cases of hemophilia A with high-responder inhibitor associated with Dieulafoy's ulcer in which treatment with a combination of endoscopic hemostatic procedure and inhibitor by-passing therapy was effective.
Both patients were very pale and in acute distress on admission. Endoscopic examination of the stomach under an infusion of FEIBA® revealed hemorrhage from an exposed artery and a diagnosis of Dieulafoy's ulcer was established. Absolute ethanol and hypertonic saline containing 0.005% epinephrine were injected into the exposed vessel and its surroundings. These procedures were performed easily and safely and local hemastasis was obtained.
This is the first reported cases of successful management of Dieulafoy's ulcer in patients with hemophilia A with inhibitor using a combination of local hemostasis with an endoscope and FEIBA® infusion.
