1989 Volume 39 Issue 1 Pages 99-104
Since the original report by Dieulafoy, there have been over 200 cases of Dieulafoy's ulcer reported in Japan.
Now we report a case of Dieulafoy's ulcer that necessitated gastrectomy due to unsuccessful endoscopic hemostasis.
A 49-year-old man was admitted to the National Numata Hospital because of sudden hematemesis during having lunch. Successful endoscopic hemostasis was performed by 95% ethanol injection. Three days later, rebleeding occurred, for which endoscopic hemostasis was unsuccessful. Then he got an emergency operation totalgastrectomy and ρ-Roux-en-Y reconstruction.
The resected specimen showed an ulcer measuring 10 × 8 mm with an exposed vessel measuring 2 mm in diameter. Microscopic examination disclosed an abnormally thick vessel in the submucosal layer, which had an inflammatory intima without microaneurysm or arteriolitis.
